Doctor and patient smiling

Effective communication is essential for the delivery of quality healthcare. Poor communication during hospitalization, and at the time of discharge, negatively impacts patient outcomes and patient satisfaction. Studies have shown the impact of teach-back in reducing readmission rates and improving patient satisfaction.

Teach-back is a communication technique used to help patients remember and understand the important information regarding their diagnosis, treatment or medication. The teach-back technique involves asking patients to recall and then explain or demonstrate the important information discussed during an interaction with their healthcare team.

Essentia Health-Fargo hospital leadership realized that their patient satisfaction (HCAHPS) scores in certain domains did not match the internal standards they had set for the organization, and they noted that while the hospital’s 30-day readmission rate was better than the national average, it had been trending upwards for the past year.

Hospital leaders had received training from Great Plains QIN staff on a communication technique called teach-back, an evidence-based communication strategy to confirm whether patients understand what is being explained to them. The team believed that if the principles of teach-back were used consistently within their hospital, they could improve their patient satisfaction scores and reduce hospital readmissions.

The improvement team developed a nine-phase action plan to implement teach-back throughout the hospital. Initial activity focused on developing a customized training program for teach-back champions and on-line training for all other nurses and case managers involved in the discharge process. Additional strategies to be implemented in the future include auditing teach-back delivery to evaluate how consistently and accurately it is being used during the discharge process; incorporating teach-back training into new staff orientation and conducting annual recertification of all staff; spreading the intervention to physicians, ancillary and ambulatory departments and all patient care interactions; and spreading the learning and implementation strategies with Essentia System leadership to establish teach-back as a standard of care throughout the organization.

“We are excited about our progress since training our nurses. Our team has recognized there are other stakeholders in patient care who would also benefit from learning and implementing teach-back and plain language. As we work toward improving quality, outcomes and readmissions we have added therapy, nutrition and physicians to our implementation plans. Bedside staff also recognize that our primary care settings have a large role in helping patients remain successful out of the hospital and therefore our ambulatory RNs will also be receiving the training. We remain focused on implementing best-practice, evidence-based interventions that will help us make a difference—teach-back is one of the ways we can accomplish this.” Kelli Sheeley, RN, CHPN, Care Coordinator, Essentia Health, Fargo

Since beginning the intervention, the hospital has trained 98.7 percent of targeted staff. Preliminary remeasurement data for the HCAHPs domains appears to show improvement in two medication communication domains, however, it is not yet possible to determine statistical significance. Adequate post-intervention implementation data reflecting changes in the hospital’s 30-day readmission rate is not yet available.

Essentia Health-Fargo has made significant strides in their comprehensive action plan to institutionalize teach-back with the intention of incorporating it throughout the entire Essentia system.

If you are interested in learning more about implementing teach-back in your organization, Great Plains QIN has free resources available to get you started. Click here to learn more.