What does making meatloaf have to do with patient’s safety?
If you make a wonderful meatloaf dinner and a friend asks for the recipe, they may wonder why theirs doesn’t come out the same.
When you share your recipe, you are telling the listener about meatloaf as you know it. If the listener uses your recipe, your information about how to make a meatloaf, it will, in fact, give them the same outcome. But what if the listener’s meatloaf doesn’t taste the same as yours?
Well…when you gave the listener your meatloaf recipe, the information was filtered through three basic areas of learning and perception: life experience, trust and expertise.
The listener heard what you said, but may have processed the information differently than you intended. For example, you said to use a pound of ground beef, an egg and a up of bread crumbs. The listener heard you but processed the recipe as flavored breadcrumbs, ground sirloin and a large egg. If you suggested a packet of onion soup mix, the listener might have processed it as Lipton Onion Soup Mix. You may use another brand. The listener was processing the recipe through her or his life experience with ingredients or other meatloaf recipes.
Let’s say that the listener is your friend and wanted your recipe and trusted you, so they did not question your recipe. But they went by their own life experience. For example. the listener’s expertise may be to use flavored bread crumbs instead of plain and sirloin, not chuck, even without you telling them to do so.
By filtering information, the listener changes the information using these three areas of processing. When a patient hears information from a doctor, the information is coming in from different people sharing the same information, in many different ways. Each time a patient hears about their diagnosis, how to treat a wound, or how to take their medication, they are being given different “recipes,” but everyone is expecting the same outcome. Each time the patient processes the information, he or she may perceive it differently and may not get the full “recipe” the way the healthcare professional expects and hopes.
To avoid this kind of miscommunication, following a conversation between doctor and patient, there needs to be a teach- back method used.
Asking the patient to repeat back what they heard is crucial for knowing if they understand what they heard, if they processed it the way it was intended, and if something may have been left out (like hearing flavored bread crumbs instead of plain bread crumbs).
The value of repeating back is helpful not only so the provider can be sure the patient heard correctly, but also it is a check that the provider may have left something out which he or she will catch in the teach-back.
Another way to be sure there is nothing missed is to have someone write information down while the patient and provider are in conversation. The writer, friend or advocate can make sure that there are no holes in directions. “Take your pill 2 times a day” is different than saying “take 2 pills a day”.
A patient who takes 2 pills at the same time, instead of in the morning and at night will not get the same response from the treatment but may in fact interpret taking the pills by filtering the information.
Next time you are given instructions and the results do not come out as you expected, think of “Making Meatloaf”.