What is Teach-back? Why is it important? How can we implement it?
By Becky C. Clem, MA, CCC-SLP, LSLS Cert. AVT – Rehab Services Education Coordinator
As pediatric health care providers, we collaborate with our young patients’ families for their care and well-being. We provide them copious amounts of information about their child in multi-media forms: printed materials, verbal instructions, video instructions, prescriptions, home exercise programs, equipment use instructions, home health supplies, referrals to specialists, appointments, internet resources, and more. Patients and families forget between 40-80% of medical information shared during office or hospital visits. Much of the medical information families do remember isn’t correct. (1)
Are we certain that families have a clear understanding of our instructions? Will the family leave the clinic or hospital with the necessary follow-up skills? Has our teaching and explanation been well defined and understandable for them?
What is Teach-back?
Always Use Teach Back! originally stemmed from the Iowa Health System and is part of the Agency for Healthcare Research and Quality’s Health Literacy Universal Precautions Toolkit. (2) Utilizing the “Teach-back Method”, healthcare professionals can make sure that the family leaves with confidence and clear understanding about their child’s care. It’s a way to confirm that we, as healthcare providers have done a good job explaining, demonstrating, and teaching families about their child’s care. Key Teach-back points are:
- Explaining information clearly
- Demonstrating techniques, procedures, equipment use, exercises clearly and easily
- Kindly asking the family member(s) to explain in their own words what’s needed for their child
- Caringly requesting and guiding family to demonstrate procedures, exercises, equipment with their child
- Reinforcing what families already know and teaching them new information
- Research-based health literacy intervention that promotes adherence, quality, and patient safety (3)
Why is Teach-back important?
At the end of healthcare related appointments, it’s routine practice to ask, “Do you have any questions?” Frequently the response will be ‘no’. The family members may be overwhelmed with the number of medications, precautions, exercises, and equipment. In all likelihood, families become dazed with information overload and cannot think of questions they want to ask! By using Teach-back, we can:
- Ensure better follow-up for the patient
- Prevent safety issues for the patient when the family has clear understanding about follow-up
- Allow healthcare providers to find out when the family needs more and/or clearer teaching
- Improve loss to follow-up or failure to comply with instructions and recommendations
- Improve outcomes for patients when families are confident and knowledge about caring for their child
How can we implement Teach-back?
At Cook Children’s, Teach-back is a key component of health literacy and family-centered care programs. Implementing it in all aspects of the healthcare system is challenging. Carrying out a systemwide initiative for Teach-back and health literacy takes time, staffing, and resources along with leadership buy-in. Much of the responsibility for training on health literacy and teach-back falls to clinical educators for both in-patient and outpatient staff. Some of the Cook Children’s strategies include:
- Videos demonstrating teach-back in simulated patient care situations on the intranet
- Slim cards for parents and families sharing about Teach-back method
- Ongoing annual competency validations related to Teach-back
- Reviving Teach-back program with clinical educators
- Individual units and departments emphasizing and utilizing Teach-back during department new hire orientation
- Workshops and computer-based training modules (CBTs) on ULearn for learning opportunities
- Family Advisory Councils’ input on use of Teach-back and materials to share with families
The AHRQ’s website has a plethora of easy to use resources to aid in implementation.
As pediatric healthcare providers, we strive to improve patient outcomes, safety, and empower families in their child’s care. Applying Teach-back method during encounters with families and our young patients engages our families for healthier children.