Format

Send to

Choose Destination
See comment in PubMed Commons below
J Commun Healthc. 2015 Mar;8(1):10-21.

The impact of teach-back on comprehension of discharge instructions and satisfaction among emergency patients with limited health literacy: A randomized, controlled study.

Author information

1
Department of Emergency Medicine, Barnes Jewish Hospital, St. Louis, MO, USA ; Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA ; Washington University School of Medicine, St. Louis, MO, USA.
2
Washington University School of Medicine, St. Louis, MO, USA.
3
Meharry Medical College, Nashville, TN, USA.
4
Department of Emergency Medicine, Barnes Jewish Hospital, St. Louis, MO, USA.
5
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis MO, USA.

Abstract

OBJECTIVE:

Recommended as a 'universal precaution' for improving provider-patient communication, teach-back has a limited evidence base. Discharge from the emergency department (ED) to home is an important high-risk transition of care with potential for miscommunication of critical information. We examined whether teach-back improves: comprehension and perceived comprehension of discharge instructions and satisfaction among patients with limited health literacy (LHL) in the ED.

METHODS:

We performed a randomized, controlled study among adult patients with LHL, to teach-back or standard discharge instructions. Patients completed an audio-recorded structured interview evaluating comprehension and perceived comprehension of (1) diagnosis, (2) ED course, (3) post-ED care, and (4) reasons to return and satisfaction using four Consumer Assessment of Healthcare Providers and Systems questions. Concordance with the medical record was rated using a five-level scale. We analyzed differences between groups using multivariable ordinal logistic regression.

RESULTS:

Patients randomized to receive teach-back had higher comprehension of post-ED care areas: post-ED medication (P < 0.02), self-care (P < 0.03), and follow-up instructions (P < 0.0001), but no change in patient satisfaction or perceived comprehension.

CONCLUSION:

Teach-back appears to improve comprehension of post-ED care instructions but not satisfaction or perceived comprehension. Our data from a randomized, controlled study support the effectiveness of teach-back in a busy clinical setting. Further research is needed to test the utility and feasibility of teach-back for routine use including its impacts on distal outcomes.

KEYWORDS:

Emergency department; Health literacy; Intervention studies; Physician–patient relations; Teach-back communication

PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Support Center