Using the Teach-Back Method in Patient Education to Improve Patient Satisfaction

Centrella-Nigro, Andrea; Alexander, Catherine

doi:10.3928/00220124-20170110-10

Cited by 46 publications

(40 citation statements)

References 9 publications

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“…Active engagement in learning such as the use of teach-back strategies have been associated with improved comprehension, more patient-centered communication, and increased engagement of parents [110–112]. Teach-back is a way of checking comprehension by asking patients to repeat back in their own words what they have been told by their health care provider [113]. However, further research is needed regarding the efficacy, feasibility, fidelity and acceptability of teach-back in an ED setting [112].…”

Section: Discussionmentioning

confidence: 99%

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

et al. 2019

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Background The majority of children receiving care in the emergency department (ED) are discharged home, making discharge communication a key component of quality emergency care. Parents must have the knowledge and skills to effectively manage their child’s ongoing care at home. Parental fatigue and stress, health literacy, and the fragmented nature of communication in the ED setting may contribute to suboptimal parent comprehension of discharge instructions and inappropriate ED return visits. The aim of this study was to examine how and why discharge communication works in a pediatric ED context and develop recommendations for practice, policy, and research. Methods We systematically reviewed the published and gray literature. We searched electronic databases CINAHL, Medline, and Embase up to July 2017. Policies guiding discharge communication were also sought from pediatric emergency networks in Canada, USA, Australia, and the UK. Eligible studies included children less than 19 years of age with a focus on discharge communication in the ED as the primary objective. Included studies were appraised using relevant Joanna Briggs Institute (JBI) checklists. Textual summaries, content analysis, and conceptual mapping assisted with exploring relationships within and between data. We implemented an integrated knowledge translation approach to strengthen the relevancy of our research questions and assist with summarizing our findings. Results A total of 5095 studies were identified in the initial search, with 75 articles included in the final review. Included studies focused on a range of illness presentations and employed a variety of strategies to deliver discharge instructions. Education was the most common intervention and the majority of studies targeted parent knowledge or behavior. Few interventions attempted to change healthcare provider knowledge or behavior. Assessing barriers to implementation, identifying relevant ED contextual factors, and understanding provider and patient attitudes and beliefs about discharge communication were identified as important factors for improving discharge communication practice. Conclusion Existing literature examining discharge communication in pediatric emergency care varies widely. A theory-based approach to intervention design is needed to improve our understanding regarding discharge communication practice . Strengthening discharge communication in a pediatric emergency context presents a significant opportunity for improving parent comprehension and health outcomes for children. Systematic review registration PROSPERO registration number: CRD42014007106. Electronic supplementary material The online version of this article (10.1186/s13643-019-0995-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

et al. 2019

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“…Prior work has often reported that health providers can be reluctant to use Teach-Back due to perceptions it can increase consultation time [ 24 , 43 , 47 – 49 ]. We did not report impact on call duration, because during the study period nurses were encouraged to focus on practising Teach-Back skills rather than meeting call duration targets, and skill learning may have temporarily inflated average call duration.…”

Section: Discussionmentioning

confidence: 99%

A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

et al. 2018

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ObjectiveTo evaluate the impact of Teach-Back on communication quality in a national telephone-based telehealth service, for callers varying in health literacy.DesignCross-sectional stepped wedge cluster randomised trial with continuous recruitment, short (fixed) exposure and blinded outcome assessors. Nurses were stratified by hours worked and randomised into training groups using a computer generated sequence.SettingAn Australian national pregnancy and parenting telephone helpline.InterventionComplex intervention involving a single 2-hour group Teach-Back training session, combined with ongoing nurse self-reflection on their communication following each call and each shift.ParticipantsParticipants were 637 callers to the telephone helpline aged 18–75 (87% female), of whom 127 (13%) had inadequate health literacy (measured with the Single Item Literacy Screener); and 15 maternal and child health nurses with 15 years’ experience on average.MeasuresPrimary outcome was a modified subscale of the Health Literacy Questionnaire, ‘having sufficient information to manage health’. Secondary caller outcomes included caller confidence, perceived actionability of information and nurse effort to listen and understand. Nurse outcomes were perceptions of their communication effectiveness.ResultsOver a 7 week period, 376 surveyed callers received usual care and 261 Teach-Back. Ratings on the primary outcome increased over time (OR 1.17, CI 1.01 to 1.32, p = 0.03) but no independent Teach-Back effect was observed. A consistent pattern suggests that, compared with usual care, Teach-Back helps callers with inadequate health literacy feel listened to (OR 2.3, CI 0.98 to 5.42, p = 0.06), confident to act (OR 2.44, CI 1.00 to 5.98, p = 0.06), and know what steps to take (OR 2.68, CI 1.00 to 7.17, p = 0.06). Nurse perceptions of both their own communication effectiveness (OR = 2.31; CI 1.38 to 3.86, p<0.0001), and caller understanding (OR = 2.56; CI 1.52 to 4.30, p<0.001) both increased with Teach-Back. No harms were reported.ConclusionsTeach-Back appears to benefit telephone health service users with inadequate health literacy, but the extent of this is unclear due to smaller numbers of lower literacy participants. Improving caller ratings over time are likely due to increasing nurse communication competence.

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“…Previous research with healthcare providers has identified four key barriers to delivering Teach-Back: perceived time constraints [ 24 , 31 – 34 ], quantity and complexity of information discussed [ 35 ], discomfort with phrasing [ 34 , 36 ] (including consumer-reported discomfort [ 37 ]), and divided attention (of parents) [ 34 , 35 ]. Enablers to the use of Teach-Back include a supportive work environment and practitioner self-reflection [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia

Morony¹,

Weir²,

Duncan³

et al. 2018

BMC Health Serv Res

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BackgroundTelehealth professionals require advanced communication skills, in part to compensate for lack of visual cues. Teach-Back is a best practice communication technique that has been recommended but not previously evaluated for consumer telehealth. We aimed to implement Teach-Back at a national maternal and child health telephone helpline. We describe the intervention and report telenurse experiences learning to use Teach-Back.MethodsWe identified barriers (time, knowledge, skills, beliefs) and enablers (self-reflection) to using Teach-Back, and developed a novel training program to address these, guided by the Theoretical Domains Framework. We engaged maternal and child health telenurses to participate in a “communication skills” study. The intervention had two key components: guided self-reflection and a Teach-Back skills workshop. For the duration of the 7-week study nurses completed brief online surveys following each call, reflecting on both the effectiveness of their communication and perceived caller understanding. At the end of each shift they reflected on what worked well. Teach-Back knowledge, skills, and beliefs were addressed in a 2-h workshop using videos, discussion, and role play. We explored nurses’ experiences of the intervention in focus groups and interviews; and analysed transcripts and comments from the self-reflection surveys using the Framework method. This study forms part of a larger evaluation conducted in 2016.ResultsIn total 16 nurses participated: 15 were trained in Teach-Back, and 13 participated in focus groups or interviews. All engaged with both self-reflection and Teach-Back, although to differing extents. Those who reported acquiring Teach-Back skills easily limited themselves to one or two Teach-Back phrases. Nurses reported that actively self-reflecting (including on what they did well) was useful both for developing Teach-Back skills and analysing effectiveness of the techniques. Most wanted more opportunity to learn how their colleagues manage Teach-Back in different situations, and more visual reminders to use Teach-Back.ConclusionsOur theory-informed intervention successfully enabled nurses to use Teach-Back. Guided self-reflection is a low-resource method aligned with nurse professional identity that can facilitate Teach-Back skills learning, and could also be applied to other advanced communication skills for telehealth. Listening to multiple workplace-specific examples of Teach-Back is recommended for future training.Trial registrationACTRN12616000623493 Registered 15 May 2016. Retrospectively registered.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-2956-6) contains supplementary material, which is available to authorized users.

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Using the Teach-Back Method in Patient Education to Improve Patient Satisfaction

Abstract: More research needs to be conducted to determine the effectiveness of teach back on HCAHPS scores. J Contin Educ Nurs. 2017;48(1):47-52.

Cited by 46 publications

References 9 publications

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

Discharge communication practices in pediatric emergency care: a systematic review and narrative synthesis

A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

Enhancing communication skills for telehealth: development and implementation of a Teach-Back intervention for a national maternal and child health helpline in Australia

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