'Teachback' as a tool in rehospitalizations
Elizabeth Leis Newman
When I was a child, I had various non-life-threatening medical problems. Any treatment, be it using an inhaler or Epi-pen, or the various buttons and ropes they used in child speech therapy circa 1988, were gone over in a huge amount of detail by my healthcare providers.
Which is why I started laughing when I came across an example Mark V. Williams, M.D., a professor at the Northwestern University Feinberg School of Medicine (Go Cats!), uses to explain “teachback.” According to a Kindred Healthcare blog written last year:
“Teachback is another important tool; the program encourages discharging clinicians to keep explanations in lay language and then ask patients to explain or show what they have just been told, to ensure they understand it correctly.”
You can see the clip he used to illustrate this below.
We don't know why this woman had such a misunderstanding around her asthma and the inhaler, but it reminds us of the problems that can arise when patients are discharged without showing they understand.
Long-term care therapists need to have thorough evaluations, including asking what the family wants to happen, and to “get patients up and moving,” noted Glenda Mack, PT, MSPT, MBA, CLT, CWS. She's Division Vice President Clinical Operations, RehabCare and made her comments during a McKnight's webcast yesterday: “How rehabilitation can improve rehospitalizations.”
But it's equally important to improve the discharge process, she notes.
“What is your strategy at the site level to ensure safe discharge?” she said. “Is there a follow-up?”
Mack noted patients who work with physical, occupational or speech language therapists can “almost have an abandonment feeling” when they are discharged.
Preparing the formal hand-off can include handouts related to exercises, instructions on when to call the provider, and notes on the date of the follow-up. Using teachback could mean making sure the resident shows you they understand how to do the exercise without you helping, or having him or her explain what they have been told about the follow-up.
As Mack noted, skilled nursing facilities are part of the answer when it comes to reducing rehospitalizations among residents. Good therapy interventions “should be unique for the patient,” she reminded.
“The most important thing is to expect an individualized course of treatment,” she added.
If you missed the webinar, you can listen to it here.
Elizabeth Newman is senior editor at McKnight's.