Health Literacy and Patient Safety

Doctor:”You have hypertension.”
Patient: “That can’t be. I’m very calm.”

Most patients know that hypertension and high blood pressure are one and the same or do they? The AMA video on Health Literacy and Patient Safety (available in the hospital library) interviews a patient who for years thought his doctor was treating him for being hyper. He had no clue that he had high blood pressure because his physician never used that term. Poor health literacy can lead to repeated hospitalization, longer hospital stays, non compliance and other adverse outcomes.

Over 90 million people in the US have poor health literacy, but few ever tell their doctor; they are just too embarrassed or ashamed to admit it. So how do we know which of our patients has a low health literacy,? Well we don’t. One strategy the AMA recommends to confirm your patient understands uses the teach back method. You could say “We have covered a lot today and I want to make sure I did not miss anything. Can you explain to me how you will take your medication?” or “I have written a prescription for XXXX, for 2 times a day, so at what time will you take them?”, or “We have talked about how you will need to use this inhaler when you get attacks. Why don’t you show me how you will use it just so I can be sure I have explained everything properly.”
Remember we want our patients to understand what we said not what they think we said.

Check out this short video on non-compliance with one of our favorite docs:
http://www.bestofyoutube.com/story.php?title=house-m-d--can-you-show-me-how-your-inhaler-works

Caroline Marshall,
Health Sciences Librarian and Health Literacy Advocate Danbury Hospital