Dr. Emily Dow

Patient Advocacy and Promoting Health Literacy Health Literacy Ability to understand health information and to use that information to make good decisions about health and medical care Ability to provide accurate and appropriate history, understand doctor’s instructions, directions on prescription bottles, making appointments, patient education brochures, consent forms Ability to navigate complex health systems

The Teach-Back Method Studies have shown that percent of the medical information patients receive is forgotten immediately and nearly half of the information retained is incorrect. One of the easiest ways to close the gap of communication between clinician and patient is to employ the “teach-back” method, aka the “show-me” method or “closing the loop.” Teach-back is a way to confirm that you have explained to the patient what they need to know in a manner that the patient understands. Patient understanding is confirmed when they explain it back to you.

Keep in mind This is not a test of the patient's knowledge. This is a test of how well you explained the concept. Use with everyone: Use teach-back when you think the person understands and when you think someone is struggling with your directions. Teach to all staff: all members of the clinic staff can use it to make sure their communication is clear.

Approaches When Using Teach-back “I want to be sure that I explained your medication correctly. Can you tell me how you are going to take this medicine?” “We covered a lot today about your diabetes, and I want to make sure that I explained everything clearly. So let’s review what we discussed. What are three things that will help you control your diabetes?” “What are you going to do when you get home?”

Health Literacy Universal Precautions Toolkit nchealthliteracy.org Prepared for Agency for Healthcare Research and Quality U.S. Department of Health and Human Services by North Carolina Network Consortium The Cecil G. Sheps Center for Health Services Research The University of North Carolina at Chapel Hill

Patient advocacy Know your patient Know the resources Find out how to link your pts to the resources

Case 1 You are working at UCIOC at Lestonnac Free Clinic and you see a pt with DM out of control who needs to be on insulin. The pt is uninsured and unemployed. She tells you that she doesn’t want to use insulin, and it’s too expensive anyway. How do you help her?

Case 2 You see a 16 year old teen who came in to clinic with her mom for a sports physical. She confides to you that she recently became sexually active. She doesn’t want mom to know, and she doesn’t want to get pregnant. What do you do? Mom wants you to do a drug test on the pt because she suspects drug use. What do you do?

Case 3 You see a 42 year old man with schizophrenia who tells you that he is hearing voices that tell him to kill himself. He has been prescribed psych meds, but he hasn’t been taking them because he doesn’t think he needs them. What do you do?

Case 4 You see a homeless man at a mobile clinic. He has been skin popping heroin, and has an obvious infection on his leg. How do you treat his infection? How do you help him in general?

Case 5 You see a woman who started working at a restaurant cutting vegetables 5 months ago. She comes into clinic complaining of numbness and tingling in her right hand for the past 3 weeks. What do you advise her?

Resources CHDP Family PACT Every Woman Counts Susan Komen Funding Emergency MediCal MediCal (CalOptima) PRUCOL Centralized Assessment Team (psych) Patient assistance programs