Strategies to Support Patient Comprehension

June 13, 2022

Reading time: 3 minutes

Chiropractor taking notes during patient intake.

A significant challenge in healthcare communication is ensuring that patients understand both verbal and written health information, including treatment explanations, recommendations, instructions, educational materials, and more.

Health information and services often are unfamiliar and confusing, and people of all ages, races, cultures, incomes, and educational levels struggle with health literacy and numeracy. Taking steps to support patient comprehension is a critical element of patient engagement and patient-centered care. The following checklist can help chiropractors evaluate their current approaches for ensuring patient comprehension and identify potential gaps and opportunities for improvement.

Do you provide verbal health information and instructions in lay language and use words that are well known to individuals?
If no common term exists for a technical term, do you explain the term the first time you use it?
Are patient forms and educational materials easy-to-read, and do they adhere to the principles of plain language?
Is information presented in a simple, organized way? Is the most important information discussed first?
Do discussions and written materials focus on what the patient needs to know and what they might want to know? Does information exclude extraneous details that could distract the patient and potentially inhibit understanding?
When possible, and with the patient’s permission, do you include the patient’s family members and significant others in discussions about the patient’s care?
Do you consider the patient’s overall capacity to understand, language barriers, cultural beliefs, and disabilities as part of communication strategies?
Does your practice have access to language services, interpreters, and assistive technologies to meet patients’ diverse needs? Are patients made aware of these resources?
Does your practice’s philosophy on informed consent reinforce the belief that patients must fully understand the information provided to be truly informed?
Is the informed consent process tailored to each patient and does it include a clear explanation of risks, benefits, and alternative options?
Do you use open-ended questions rather than closed-ended questions to facilitate more meaningful communication?
Do you use a technique such as teach-back or show-me to gauge patient comprehension and reduce the risk of miscommunication?
Do you encourage patients to ask questions, and is ample time allotted for questions and review of materials during patient appointments?
Do you provide follow-up instructions verbally and in writing to reinforce the information? Do you provide patients with updated written instructions if changes in their care plans occur?
When patients are nonadherent to treatment plans, do you consider and assess whether they might not understand information or have health literacy barriers? Do chiropractors and staff members at your organization receive training about health literacy barriers and techniques to improve communication and patient comprehension?


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This document should not be construed as medical or legal advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.

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