New respiratory technologies and products are emerging almost daily, and this product focus issue is testament to the ingenuity and forward thinking of the developers of respiratory care products. All of this is of no avail, however, if the very patients for whom these products are developed do not understand the nature of their illnesses or how to use the products prescribed for treatment.

Health care illiteracy is a growing concern in the health care industry, with about half the US adult population having difficulty using text to accomplish everyday tasks, 5% are nonliterate in English, and 29% have less than basic literacy skills. To address this problem and offer solutions, The Joint Commission has published a white paper, “What Did the Doctor Say? Improving Health Literacy to Protect Patient Safety.” The paper’s overarching theme is improved communication between patient and provider, and, while much of the solution to communication problems lies in health care facilities’ policies, there are things that individual RTs can do to ensure that their patients understand what they need to do to prevent adverse events.

Here are some “for instances:” Hospital-based RTs can use treatment sessions at the bedside to explain how to properly use aerosolized-medication devices and when to use them, home care RTs can educate patients in the use of oxygen devices and how to properly care for a tracheostomy, and sleep lab techs can educate patients about the risks of OSA and how to use CPAP devices. Opportunities abound. The important thing is to provide self-management education to patients that is customized to their learning and language needs.

Many patients with low literacy skills feel inadequate and are ashamed to admit that they do not read well or understand. Some might have been suffering silently because they have not understood all that they have been told about their conditions and their treatment. Health care professionals need to assume that the patient does not understand and must use communication techniques that are known to enhance understanding:

  • Use plain language
  • Use “teach back and “show back” techniques to assess and ensure patient understanding
  • Limit information to two or three points at a time
  • RT’s  Calendar of Events
    is now online!
    To find out what’s coming up in the future or to add your own event, go to “CALENDAR.” You will see the calendar and instructions for submitting your entry. I hope you will take advantage of this opportunity to spread the word about what your group is doing         —mb
  • Use drawings, models, or devices to demonstrate points
  • Encourage patients to ask questions

There are questions to answer when assessing how well education is working, according to William C. Pruitt, MBA, RRT, instructor, Department of Cardiorespiratory Care, University of South Alabama, Mobile. Among them: Will the therapists have time to teach and answer questions (workload issues), will they take the time (motivation), is the teaching accurate and effective, are barriers to education being removed, are family members being included, and is the education appropriate to the age and health of the patient?

Communication breakdowns between care providers and their patients are the primary root cause of the nearly 3,000 sentinel events—unexpected deaths and catastrophic injures—that have been reported to The Joint Commission. All of you, especially those of you in policy-making positions, can impact that figure by making effective communications a priority at your organizations by raising awareness of the impact of health literacy and English proficiency on patients’ safety.

—Marian Benjamin
[email protected]

Joint Commission white paper available at