Monthly Archives: January 2016

Clear as mud: what is going on, did the message get across?

Time and time again reports and reviews identify communication as the crucial element that is lacking or gone awry; lost in the muddy waters of the moment. Health literacy is the degree to which people obtain, communicate, understand and process health decisions, health information and access the right service. This shapes decisions, health outcomes and adherence to treatments. The Australian Bureau of Statistics and Australian Commission on Safety and Quality in Health Care indicate up to 50% of Australians have low health literacy.

Palliative care is portrayed as the hand- holding, talking sector. The ‘experts’ in breaking bad news and having difficult conversations. When in actual fact, good palliative care is based on good communication (as well as many other things). On occasions, referrals to palliative care are because of underlying communication issues such as poorly delivered information or poor understanding impeding decision making or consensus for care, all which link to health literacy.

At a practical level, health literacy means meeting the needs of people with a range of understanding, while not making assumptions about individual health literacy levels. It involves confirming understanding at each point of contact, providing easy access to health information, services and helping to navigate our complex health system.

One technique is Ask-Tell- Ask (R. Arnold et al). Ask about a person’s current understanding, identify the most important issue for the person. Tell, share information by giving 2-3 key points in straight forward language. Ask again, check their understanding of what was said or what they are going to do; using straight forward language.

There are many opportunities for clinicians to mentor and support each other in developing confidence in communication. Health literacy is important within organisational quality and communication initiatives. There is always a way to communicate.