information partnership training section 4.pdf · 2020-04-24 · information partnership training...

Information Partnership Training

Meaningful information

for shared decisions in health and social care

4overcome barriers to understanding

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We have seen that finding good quality information is important, and Steps 1-4 of the model as outlined in Section 3 can help. But when you hand over the leaflet/print-out, or tell the person what you have found, you cannot take it for granted that the person understands it, and can see what it might mean for them.

Going through Steps 5-7 of the model can help you with this. These steps are:

Step 5 Combine Checking how information from different sources fits together and relates to what you already know.

Step 6 Share Checking that when you share the information, there are no barriers to understanding and it makes sense to the person.

Step 7 Apply Checking that the person can see how they could use the information.

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e barriers to understanding4

Information Partnership Training for shared decisions in health and social care 2

Discussion points

4.1 How to COMBINE new information with what is known

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overcome barriers to understanding

It is important to think about how new information fits in with what is already known. This helps to make the information meaningful for that person.

Activity 4A What would you do in the following situation?

You have found some addresses of local support groups for an enquirer who is a wheelchair user. You know that one of the support groups meets in an old building which has stairs at the front entrance. You are not sure if there is wheelchair access.

You may not mention the support group which meets in the old building because you think it is not accessible. You don’t want to give wrong information or embarrass the enquirer.

You give the enquirer the information about all the support groups and discuss with them how to check the accessibility issue. The enquirer may know whether the venue is accessible or not. They may wish to check for themselves.

You ask the client if they would like you to check accessibility by phoning the venue.

If the venue is not accessible, you could ask if the support group can be accessed as an outreach service.

If the venue is not accessible you could discuss with the client about giving feedback to the support group about accessibility.

It is important not to ‘gate keep’ information from anyone. You need to combine and share all the information that you both have and discuss the best approach together.


Discussion points

All of these are to do with understanding we are all different. Sometimes this may mean that it would be better for someone else to provide the information e.g. an enquirer may prefer to speak to someone of the same gender.

3 The equality duty covers: age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation and marriage and civil partnerships.

For more information www.equalityhumanrights.com

4.2 How to SHARE information so there are no barriers

Check that when you share the information, there are no barriers to understanding and it makes sense to the person.

Activity 4BWhat do you think might be barriers to understanding? (they may be things you have experienced too).

Some of the barriers to understanding may be: Jargon or very technical terms are used

Too much information is given all at once

Literacy issues – e.g. not confident reading

Communication issues – e.g. an older person who is hard of hearing

English is not their first language

Lack of privacy to have the conversation

Equality issues3

The enquirer’s feelings and attitudes – their anxieties and lack of confidence and how they perceive you.

Your feelings and attitudes – your anxieties and lack of confidence and how you perceive them.

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Discussion pointsActivity 4CThe enquirer comes in to the local community health project to find out how to see a doctor. You realise that English is not his first language, that he is quite confident in speaking, but less so in reading. You check but do not have the leaflet in his language so you need to use a leaflet in English which gives all the information. You sit down with him and go through the leaflet together simplifying each section. You check his understanding by asking him to tell you what he is going to do. You clarify points where needed and check his understanding again. You suggest he takes the leaflet with him but can come back anytime to get some more help.

Think about the practical things that you did to help. Did you? Go over things at a pace that suited?

Think about your personal approach. Were you patient, interested, reassuring, understanding?

Use simple words and short sentences?

Explain any technical terms?

Check if he needed a translator?

Check if he understood, rather than assuming he did? One technique to use is called ‘Teach Back’. It is a simple approach to checking understanding.

Don’t ask Do you understand? or Do you have any questions?Do ask I want to be sure I was clear. Can you tell me in your own words how you can see a doctor? orTo be sure I’ve explained this clearly, please tell me how you would describe this to your friend? orCan you tell me, in your own words, how you would take this medication?


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Activity 4D Understanding Teach-back training

35-40% of patients leave an appointment with a health professional without really understanding what their main health issue is, what they should do about it and why. Approximately 50% of patients do not take prescribed treatments as recommended.

Discuss the following questions1. Why does this happen?2. What are the consequences?3. Which patients are at most risk?4. How do you ensure a client/patient understands

the information?

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Discussion points

1. Why does this happen? (use of jargon, use of unfamiliar phrases, lack of checking for understanding or denial.)

2. What are the consequences?

Greater risk of admission to emergency services

Making more mistakes with medication and treatment plans

Less knowledge of how to manage their disease

Less knowledge of healthy lifestyle behaviours

Less able to make informed choices about their healthcare and treatment

Less able to make use of preventative services

3. Which patients are at most risk?

Not just those with low literacy and numeracy skills, but also lower socio economic groups, ethnic minorities, older people and those with chronic or disabling conditions.

4. How do you ensure a client/patient understands the information?

The only way to know for sure whether your enquirer understands is by asking. One technique is the “teach-back,” where you ask the person to retell in their own words (i.e. teach back) key points just discussed. This allows you to check understanding and repeat anything if necessary.

Example 1 Someone has asked you for information about carers support groups in your local area. What might you ask them to check their understanding of the information you have given them?

You might say ‘I know we’ve covered a lot today and I want to be sure I’ve explained it all to you. Can you explain who you are going to contact so that I can be sure I have explained everything correctly?’’

Example 2 Someone has asked you for advice on flu vaccinations for their partner. What might you say to them to check that they have understand the information you have given them.

You might say, ‘I want to be sure I’ve explained everything clearly. When your partner gets home tonight what will you tell him about flu vaccinations?’


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Information needs to be accurate. But there’s a lot we can do to help make sure people understand it.

If you are working with people using languages other than English the following may be helpful:

Health in My Language: translated information about health and health services in Scotland. http://www.healthinmylanguage.com/home.aspx

Health Rights Information Scotland – for translations, British Sign Language, and other formatshttp://www.hris.org.uk/

Edinburgh Mental Health Information –for information on mental health issueshttp://www.edspace.org.uk/default.asp?page=23&fsid=18

See additional sources of information for health and social care in Appendix 5.

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Discussion points

4.3 How to check someone can use (APPLY) the information.

We should check that people can understand the information, but we should also check whether the person can use it in their situation.

Activity 4E Think about this situation. What might you do?

Someone has asked for information about a health condition and how it can develop. The information says that the condition can vary – some people may be only mildly affected, for others it can be much more serious. Your enquirer gets quite upset when he reads this.

Find out why they got so upset? Don’t assume it is because of the condition. It may be the possible consequences of the condition. This may require different support or information to be signposted. E.g. someone who has been diagnosed with MS may have immediate concerns about the financial and emotional impact on their family.

You may wish to go through the information again, and try to point out again that people can be differently affected.

Suggest they should contact their GP.

Help them to find information about support group and helplines.

Suggest they take it home and perhaps read it again when they are not so upset.

The important point is that there may be something you can do to help the person get the best use out of the information.


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4.4 Reflections on your situationAdd here any additional points you may have thought of, or points raised in your discussions with managers, colleagues, and partners, not already highlighted which may be useful for your own situation.

4.5 Key Learning PointsOnce we have found the information to answer a question, we also need to:

Combine any new information with what is already known

Share the information effectively, by checking there are no barriers to understanding

Apply the information, making sure that the person can use it and see that it is meaningful to them in their situation.

For further information on this please see www.infoliteracy.scot.nhs.uk.

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Quick quiz: Making information meaningful

1 What are three steps to making information meaningful? Match the following three steps with the descriptions which follow:

1. Combine

2. Share

3. Apply

a) Checkthatwhenyousharetheinformationthattherearenobarrierstounderstanding

b) Checkthatthepersoncanseehowtheycouldusetheinformation

c) Checkhownewinformationfitsinwithwhatyoualreadyknow

2 Match the following four steps with the descriptions which follow:

1. Explain everything

2. Use a personal approach

3. Use language

4. Check understanding

a) whichispatientandinterestedb) whichissimpleandclearc) usingapacewhichissuitabled) byaskingthepersontorepeattheinformation

intheirownwords


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Quick quiz: Making information meaningful

For further information and advice please contact:Knowledge Services Group, NHS Education for Scotland, 1 Clifton Place, Glasgow G3 7 LD Tel: 0141 352 2800email: [email protected] www.knowledge.scot.nhs.uk/home/portals-and-topics/information-partnership.aspx

3 Look at the following statements. Which of the following may be barriers to understanding when you are giving information? Write Yes if you think it may be a barrier and No if it is not.

a) Your client cannot read confidently.

b) The information has a lot of technical terms.

c) Your client’s first language is not English.

d) You use simple words and short sentences to explain.

4 Using Teach Back technique

Which of the following phrases would you use if you were using the teach back technique to check if someone understood the information you are giving them. Please answer Yes or No

I want to be sure I was clear. Can you tell me in your own words how you can see a doctor?

Do you understand everything I have told you?

Do you have any more questions for me?

Can you explain who you are going to contact so that I can be sure I have explained everything correctly?

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information partnership training section 4.pdf · 2020-04-24 · information partnership training...

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