What do you do if patients struggle to understand your healthcare instructions?

1. Simplify Language: Break down complex medical terms into simpler language. 2. Visual Aids: Use diagrams or videos to illustrate instructions. 3. Feedback Loop: Encourage patients to ask questions and confirm understanding. 4. Demonstration: Show procedures like medication intake or wound care. 5. Technology: Provide written instructions or use health apps for reinforcement. 6. Follow-Up: Check in with patients to ensure they're following instructions correctly.

In my experience as a clinician but also when I was an investment banker, speaking the language of your audience was critical to success. Whether an audience of 1 (a patient or your client), more than 1 (patient and their family or patient + caregivers), or large group, speaking in not just the language but tone and pace was important to being effective and impactful. Rule #1: Don't use jargon. Rule #2: Read rule 1 Rule #3: After giving instructions, thank them for their time. They are looking to you for answers and are full of all kinds of thoughts/worries/anxieties/etc. Take a moment to give grace and gratitude.

In all phases of our clinical practice, we should be seeking to understand our patient as an individual and the context in which they are engaging with healthcare. If we have reached the point where a patient is not understanding our healthcare instructions, we can use this as an opportunity to evaluate where we may have missed crucial tidbits related to our patient that will inform our practice. Rather than a one size fits all approach, we should approach each patient as an expert in their own life and solicit feedback on how we can be effective in their care. How do they best retain information? Do they have imporant individuals they want involved in their care? Not only does this strengthen the rapport but it improves outcomes.

Rule #1: KYC/KYA: Know your customer/Know your audience Rule #2: Use the language they're familiar with, can relate to Rule #3: Don't use jargon

Listen to client. Use language that is understood by the average person (forget the medical jargon, unless it is well explained). Answer questions and avoid panic. I had a client ask me about her dog who was showing signs of renal failure. She asked me if this was like stage 4 cancer, that she had just been diagnosed with. I took the time to talk with her, and the steps their household could adopt to help her dog (blood tests, nutrition etc) while addressing the owner's concern about her safety. example : have other household members bring her dog for visits and follow up so the owner could 'protect' her health. This was before smartphones, but email did help. The interaction was usually done over the phone.

Leverage technology and an omnichannel approach to reinforce key points and repeat instructions. This can be done by setting up scheduled reminders or asynchronous methods: email, text, social media etc. But ask what method is preferred because you can segment your patients in this way. Some like email, some prefer text nudges. But the aim is the same: reinforce in a gentle effective way not forceful, because it may turn them off.

When engaging with patients, its important to purposefully leave time for Q and A. It's where you'll get the most value out of the engagement. Because allowing time and space for patients to ask questions give them a level of power in the dynamic where they can ask clarifying questions, ask for resources, or something else. Leverage your listening skills and acknowledge what they're saying. Sometimes take time and say: "So what I am hear you saying is the following..." to give a genuine feeling of you engaged with them at their wavelength. It will go a long way and make you feel like a partner in care vs the deliverer of care.

Provide options and remember it's okay to say "I am not sure", but will get back to you. Remember a referral is sometimes the best option if this is affordable. The use of smartphones has enabled clients to record their pet's progress with medical or surgical recovery.

Leverage your family and create a safe and honest environment of how to use each caregiver and family member wisely. This will prevent any one member from feeling overwhelmed or guilty. Clear communication is really really important here.

Follow up and evaluation can be done with technology, in this day and age. If your team can have someone to reach out days after instructions were given---days, weeks, etc to check-in on progress---in order to get status report, you'll be delivering high quality care. Also by providing an easy way to record whatever it is you want them to keep track of provides a good way to ensure compliance, likely a better outcome, and an engaged patient.

Follow up is vital and involving other family members can help so much. Technology has allowed this to be much more precise and 'in the moment'. Answer questions, ask questions. Follow up can be a daily status, weekly status or monthly report. Sharing of lab results in writing visually helps the client understand and in an emergency share with an emerg. clinician.

Here’s what I did in medical school: record myself sharing the instructions and share it with patient who can then share it with their family. Have a recording to refer to, on their phone, available whenever they need it. It beats a piece of paper that might get lost on the car floor.

Closing the gap on health literacy requires healthcare providers to step into the 21st century like almost every other industry has, by investing in digital. If you think back to financial services 10 or so years ago, no one really understood what they were signing up to and whether there were alternative options, but through digital platforms, consumers are in control of their finances more than ever, but sadly, we can’t say the same about healthcare. Digital platforms allow the healthcare provider to deliver information in multiple modalities (videos, fact sheets etc) and provide the patient the opportunity to consume content in the privacy of their own home and share the information with their family & friends for further discussion.

Be creative in communication techniques! One extremely innovative solution that was built on the AvoMD platform leverages LLMs to communicate with patients: Take this inpatient example: -> Physician assesses patient is ready for discharge (d/c) -> Nurse utilizes the Algo which will import patient’s d/c meds, create a digital information packet for the patient to read, and finally assess their understanding with a 10-question quiz written dynamically based on the specific meds. -> Care team clarifies the understanding gaps LLMs will be able to both help clinicians *learn* how to communicate better, and help with the actual communication, as per the above example!