Make TeachBack an ALWAYS Event Presented by Laura

Make Teach-Back an “ALWAYS” Event Presented by: Laura Brown, MLS Clinical Librarian Dhruti Ramchandani, MPH, CHES Senior Health Education Specialist

Health Literacy Quiz Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and obtain services needed to prevent or treat illness. What percentage of people are at a proficient level of health literacy?

Quiz Answer • 12 percent of adults had proficient health literacy • The majority of adults (53 percent) had intermediate health literacy • 22 percent had basic health literacy • 14 percent had below basic health literacy (Baldi et al. , 2009)

Evidence of the need – Only 12 % of adults have a proficient level of health literacy (Baldi et al. , 2009) – 40 -50% of information given to patients is forgotten immediately (Mc. Guire 1996) – Almost half of what was remembered was incorrect (Anderson, Dodman, Kopelman, & Fleming, 1979)

Teach-back is… 1. Asking people to explain in their own words what they need to know or do, in a friendly way 2. NOT a test of the patient, but a measure of how well you explained something 3. A way to check for understanding and, if needed, re-explain, then check again AHRQ, Making Health Care Safer, 2001; Schillinger, 2003

Teach-back Examples • We talked about what are good for you to eat. Can you give me a sample of a day’s menu? • We’ve gone over a lot of information and a lot of ways you can get more exercise. In your own words, can you go over what we talked about? How will you do it safely at home? • Let’s make sure the paperwork gets handled right. Can you tell me what you will do with these forms? • We went over how to care for your catheter. Will you walk me through the steps you need to take when changing the dressing to make sure I explained them clearly?

The Evidence • AHRQ, 2001, Making Health Care Safer. “Asking that patients recall and restate what they have been told” one of 11 top patient safety practices based on strength of scientific evidence. • Schillinger, et al. , 2003, Closing the Loop Physician use of TB associated with better glycemic control for diabetic patients. • Bennett, et al. , 2009, J Am Coll Radiol (Humorous) diagram (6. 8”) & TB (8. 1”) better recall & recognition than standard consent (5. 8”) for spinal injections. • Fink, et al. , 2010, Annals of Surgery Addition of repeat-back to standardized computerbased consent program significantly improved patient comprehension. • Press, et al. , 2012, J Gen Intern Med Use of TB associated with lower MDI misuse among hospitalized adults w/ asthma or COPD. (NS reduction for Diskus®) & fewer 30 -day acute health events. • Kaphingst, 2013, HARC Use of TB improved understanding of post-ED meds, self-care, & f/u compared to standard discharge among adult patients w/ low HL discharged from ED.

Learning Module • Most of the tools we will be modifying for our use come from www. teachbacktraining. org • They were developed jointly in Iowa: – – Unity. Point Health Picker Institute Des Moines University Health Literacy Iowa • If you want to get a head start on learning Teach-back, invest 45 minutes in the Interactive Teach-back Learning Module http: //www. teachbacktraining. org/interactive-teach-back -learning-module