Can Patient Safety Be Improved By Asking Three Questions?

This is Patient Safety Week. Patient safety may bring to mind infections acquired in hospitals, but we know strides are being made to make hospitals, health centers and other patient care facilities much safer for patients.

But what are medical practices doing?

Ask Your Doctor Questions to Improve Patient Safety in the Clinic

According a recent article in JAMA, primary care practices need to work harder at patient safety, but for reasons that might surprise you. The article cites communication and process issues as key to creating potentially unsafe situations for patients.

One barrier to good communication is health literacy. Health literacy is defined by an Institute of Medicine report as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Health literacy affects the health of  90 million people in the U.S. spanning all ages, races and income levels. According to the National Patient Safety Foundation (NPSF), “literacy skills are a stronger predictor of an individual’s health status than age, income, employment status, education level, or racial/ethnic group.”

Ask Me 3

One initiative that is a step in the right direction is the Ask Me 3 Program that the NPSF developed as part of the Partnership for Clear Health Communication (PCHC.) It encourages patients (and encourages physicians to encourage patients) to ask 3 Important Questions in any healthcare situation. The NPSF states:

Patient engagement remains a critical untapped lever in the health care environment. In advance of Patient Safety Awareness Week, NPSF has released a new video derived from its Ask Me 3 program, a patient education program designed to promote communication between health care consumers and providers. The program encourages patients to ask and understand the answers to three questions:

    • What is my main problem?

    • What do I need to do?

    • Why is it important for me to do this?


What research supports the use of Ask Me 3?

The Pfizer Health Literacy website says:

A recent study by The University of Texas Health Science Center at San Antonio measured the results of implementation of Ask Me 3 in a pediatric health center. Of the 393 parents surveyed (of which 31 percent were Spanish-speaking only), 100 percent “liked” the program and felt the questions “helped them get more information about their child’s health.” Perhaps the most interesting result of the study was a shift in the parent’s perception. The parents felt that the doctor spent more time with them, even though the study did not show any increase in the office visit time.

In a separate study conducted by the American Association of Family Physicians, 21 physicians who used the Ask Me 3 program (the intervention group) reported higher levels of visit satisfaction than 17 physicians in the control group that practiced standard care . Greater than half (52 percent) of the intervention physicians reported that when their patients asked at least one of the Ask Me 3 questions, their own communication with patients was improved. Additionally, two-thirds (65 percent) of the 443 patients who used the Ask Me 3 program felt their communication with their providers had improved as a result of the program.

In both studies, the time spent in the provider’s office did not increase when Ask Me 3 was implemented.

The short video below explains how Ask Me 3 works, and would be a great video (free!) to put on YOUR medical practice website or show in your reception area as a part of your Ask Me 3 campaign to improve communication. Other Video Resources for patient-physician communication can be found here.


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