Health Literacy Universal Precautions Toolkit, 2nd Edition

Communicate Clearly: Tool #4

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Using clear oral communication strategies can help your patients to better understand health information. Communicating clearly also helps patients to feel more involved in their health care and increases their likelihood of following through on their treatment plans.

Practice Experiences
Patients misunderstand health communications more often than clinicians might think. For example, one practice using Tool 4 shared a story of a clinician who told a patient that they could not use a local treatment to heal her wound. The patient thought she was going to have to travel to another city for care (instead of understanding that she could not use a topical treatment).
–Family practice facility


Use strategies for communicating clearly.

  • Greet patients warmly: Receive everyone with a welcoming smile, and maintain a friendly attitude throughout the visit.
  • Make eye contact: Make appropriate eye contact throughout the interaction. Refer to Tool 10: Consider Culture, Customs and Beliefs for further guidance on eye contact and culture.
  • Listen carefully: Try not to interrupt patients when they are talking. Pay attention, and be responsive to the issues they raise and questions they ask.
  • Use plain, non-medical language: Don't use medical words. Use common words that you would use to explain medical information to your friends or family, such as stomach or belly instead of abdomen.
  • Use the patient's words: Take note of what words the patient uses to describe his or her illness and use them in your conversation.
  • Slow down: Speak clearly and at a moderate pace.
  • Limit and repeat content: Prioritize what needs to be discussed, and limit information to 3-5 key points and repeat them.
  • Be specific and concrete: Don't use vague and subjective terms that can be interpreted in different ways.
  • Show graphics: Draw pictures, use illustrations, or demonstrate with 3-D models. All pictures and models should be simple, designed to demonstrate only the important concepts, without detailed anatomy.
  • Demonstrate how it's done. Whether doing exercises or taking medicine, a demonstration of how to do something may be clearer than a verbal explanation.
  • Invite patient participation: Encourage patients to ask questions and be involved in the conversation during visits and to be proactive in their health care.
  • Encourage questions: Refer to Tool 14: Encourage Questions for guidance on how to encourage your patients to ask questions.
  • Apply teach-back: Confirm patients understand what they need to know and do by asking them to teach back important information, such as directions. Refer to Tool 5: Use the Teach-Back Method for more guidance on how to use the teach-back method.

Help staff remember these strategies.

  • Review these strategies with staff during staff meetings, and hang the Key Communication Strategies poster in non-patient areas (e.g., kitchen or conference room) as a reminder.

Track Your Progress

Before implementing this Tool, ask all staff complete the brief Communication Self-Assessment after a few patient encounters. Calculate the percentage of staff who completed the self-assessment. One month after beginning implementation, complete another round of self-assessments and look for changes.

Before and after Tool implementation, ask a respected individual to conduct observations of clinician/staff interactions with patients. Use the Communication Observation Form to assess communication quality. Provide feedback to staff. Repeat this process routinely. Calculate the percentage of staff who have been observed once, and the percentage who have been observed more than once.

Before implementing the tool, collect patient feedback using the Brief Patient Feedback Form or the more comprehensive Health Literacy Patient Survey in Tool 17: Get Patient Feedback. Administer the questions 2, 6, and 12 months later, to determine if there has been improvement.


Health Literacy and Patient Safety: Help Patients Understand, by the American Medical Association, offers suggestions for improving oral communication and alternatives to complex medical words (pages 29-34). Once you link to the Web site, look for the Manual for Clinicians. Access to the manual is free, once you have created an account.

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Page last reviewed February 2015
Page originally created February 2015
Internet Citation: Communicate Clearly: Tool #4. Content last reviewed February 2015. Agency for Healthcare Research and Quality, Rockville, MD.
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