Risk Management Tips: Communicating with Low Health Literacy Patients

The Tip:
The public often has limited knowledge and understanding of medical diagnoses and terminology. Low health literacy is a significant problem in the United States. According to the Agency for Healthcare Research and Quality, only 12 percent of U.S. adults have the health literacy skills needed to manage the demands of our complex healthcare system. A patient’s ability to understand medical information also may be compounded by stress, age, illness and language or cultural barriers.

The Risk:
Lack of health literacy can make effective communication with patients a challenge. At stake may be inability to comply with treatment regimens, give informed consent and use medication properly.

Recommendations:
Healthcare organizations and physician office practices can improve patient safety and satisfaction and reduce potential liability exposure, by employing the following tactics:

1. Use lay terminology whenever possible. Define technical terms with simple language. Patient education materials should be written in plain language, avoiding the use of medical jargon.

2. Verbal instruction may be reinforced with visual aids and printed materials that are easy to read and include pictures, models and illustrations. Consider using non-printed materials, such as videos and audio recordings, as indicated.

3. Offer to assist your patients when completing new patient information or any other practice documents. Provide this help in a confidential way, preferably in an area that is private and conducive to this type of information exchange. Encourage your patients to contact you with any further questions. Additional assistance and/or the use of interpreters may be indicated for patients who are not fluent in the English language.

4. Use open ended questions rather than yes/no questions to further assess patient understanding. At the end of an encounter, instead of asking “Do you have any questions?” try asking “What questions do you have for me?”

5. Providers and staff should be familiar with and utilize the principles of “Teach Back” when reviewing new medications or treatment plans with patients: teach a concept—then ask the patient to repeat back the information they just heard using their own words.

6. Patients and family members may be embarrassed by, or unaware of, their healthcare literacy deficits. An empathetic approach to understanding patient health literacy will enhance your physician-patient relationship.

This “Risk Management Tip” was originally published in the Spring 2015 edition of Dateline, which is available here.