Health Literacy Universal Precautions Toolkit, 2nd Edition

Welcome Patients: Tool #13

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Do your patients feel welcome when they enter your practice? Have you clearly identified how to get to common locations, like the restroom or the check-out desk? Do patients face a barrage of paperwork when they first come in?

Some patients may feel anxious or intimidated when navigating a practice. This may be more problematic for new patients and for those with limited health literacy. Creating a friendly and easy-to-navigate environment may help your patients feel welcome and relaxed.


Assess your practice.

  • Shadow patients or conduct a walk through. Tool 17: Get Patient Feedback describes how to walk in the shoes of your patients to assess how welcoming your practice is.
  • Review signs throughout your practice. Check with your clinic administrator to see if a review and approval process is required to change signs in your practice. Look at all the signs in your practice, and make sure they:
    • Are visible and easy to read.
    • Provide clear direction. Use signs to identify and direct patients to common locations, such as the practice entrance, the check-in and check-out areas, exam rooms, lab, and restrooms.
    • Are written in appropriate languages (i.e., written in the language(s) most commonly understood by your patients).
    • Use graphics when appropriate. 
  • Consider other approaches to help patients find their way, such as color-coded lines on the floors or walls.

Train staff.

  • First impressions count. The first person a patient talks to should be helpful and cheerful. Use the guidance in this tool to train front desk staff on how to create a helpful and health literacy-friendly atmosphere for your patients.
  • Don't forget the back office. Patients with billing questions often find it difficult to understand procedure codes and insurance practices. Teach your staff to provide easy-to-understand explanations of common billing and insurance concepts that avoid technical jargon.
  • Go to Tool 3: Raise Awareness, Tool 4: Communicate Clearly, and Tool 7: Improve Telephone Access for additional guidance on training staff.

Offer everyone help with forms.

  • You can't tell by looking which patients may need assistance, so offer all patients help with the forms that they are asked to fill out or sign.
  • Offer help in a friendly, non-stigmatizing way. For example:
    • "I am going to give you these forms to complete. You can fill them out now or wait until you get to the room and the assistant will be happy to go over them with you."
    • "If anything on the form is not clear, let me know and I'll be happy to go over it with you."
    • "Thank you for filling out the form. Can we go over it to be sure we got everything? Some questions are not always clear and we want to be sure we have the correct information."
    • Make sure information collected from patients is shared with everyone who needs to know so the patient is not repeatedly asked for the same information.

Assess language preferences.

Create a practice brochure.

  • Use tips from Tool 11: Assess, Select and Create Easy-to-Understand Materials to develop an easy-to-understand brochure highlighting key elements of your practice, such as:
    • Contact information, including after-hours and emergency information.
    • Services provided.
    • Address and directions to your office.
    • What to bring to appointments.

Use the waiting room to display important information.

  • Use the space in your waiting room to share important information, but don't overwhelm patients with too much material on walls or tables.
  • Display posters to raise awareness about your practice's quality improvement work and to educate patients about important concepts, such as:
  • Display photos of practice staff, including names, titles, and key responsibilities, to help patients better understand the roles different staff members play. Remember to use simple words (e.g., use "doctor" and "nurse" instead of "physician" and "RN").
  • Use bulletin boards as focal points in your lobby to arouse patient interest, stimulate thought, and encourage action.
  • Ensure that all materials displayed in your waiting room are:
    • Targeted at your audience: Your patient population.
    • Organized around a central theme: Contain no more than four points of interest.
    • Easy to understand and colorful.
    • Updated regularly: Assign staff to update content on a regular basis.
  • Provide easy-to-understand patient education materials. Make sure written patient education materials in your waiting room are easy to read and understand (go to Tool 11: Assess, Select, and Create Easy-to-Understand Materials). Rather than providing numerous pamphlets, select those materials that are most relevant to your patient population.
  • Use video and television programming. If you have a television in your waiting room, use it to show easy-to-understand health-related information.

Track Your Progress

Conduct an initial assessment of your practice environment by asking a patient or staff member to walk through your practice and assess the points addressed in this Tool. After making changes and offering staff training, conduct additional walkthroughs and compare the results. Ask patients if they were offered help with forms. Alternatively, have an observer in the reception area record the percentage of patients who were offered help with forms. Track the percentage over time.

If you field questions from the Health Literacy Patient Survey, calculate what percentage of patients responded "Always" to question #26.

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Page last reviewed February 2015
Page originally created February 2015
Internet Citation: Welcome Patients: Tool #13. Content last reviewed February 2015. Agency for Healthcare Research and Quality, Rockville, MD.
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