JHQ 322: Health Literacy and Cardiac Medication Education: A Quality Improvement Study Using Teach-Back-JHQ 322 Article

JHQ 322 Article

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This quality improvement study evaluated whether the teach-back method could improve patient understanding of newly prescribed cardiac medications at hospital discharge, addressing communication gaps associated with limited health literacy and social determinants of health. Conducted on a telemetry unit in a university-affiliated community hospital in New York, the project aimed to raise the proportion of patients who could correctly state both the indication and potential side effects of new cardiac medications to at least 85% by January 2024, using a Plan-Do-Study-Act framework.<br /><br />Fifty eligible, English-speaking patients discharged home (mean age 71.7 years) completed a baseline assessment. Although patients first answered yes/no screening questions about whether they knew why the medication was prescribed and its adverse effects, they were only counted as understanding if they could accurately explain both in their own words. Those with knowledge gaps received tailored, plain-language education delivered by trained medical students, residents, or nurses, followed by a teach-back session to confirm comprehension. Retention was reassessed via blinded telephone interviews 2–4 weeks after discharge using the same approach.<br /><br />At baseline, 54% of patients understood the purpose of their new medication and only 26% knew potential adverse effects. After teach-back education, 92% could accurately describe both indication and side effects, exceeding the project goal. At follow-up, 74% retained this knowledge. The project used standardized scripts, checklists, and blinded follow-up interviewers to reduce bias, though results were descriptive without formal statistical testing.<br /><br />The authors conclude that teach-back is a feasible, low-cost intervention that substantially improves immediate comprehension and short-term retention of discharge medication instructions in inpatient cardiology settings, supporting safer transitions of care and providing a foundation for broader implementation through workflow integration and multidisciplinary training.

Keywords

teach-back method

discharge medication education

cardiac medications

patient understanding

health literacy

quality improvement study

Plan-Do-Study-Act (PDSA)

telemetry unit

medication side effects knowledge

transition of care