CLIENT SERVICES
How to Improve Your Clients' Health Literacy with Better Communication typography
Illustration of a woman examining various health themed icons with a magnifying glass

By Louise Dunn

T

ime spent talking to clients in the exam room can be difficult. Between the interruptions, the focus on documenting on the computer, cell phone use and language barriers, is it any wonder conversation can occur? However, there is another communication barrier to be aware of. This one is often “silent,” but it can easily affect over 36% of your clients.1 It is called “health literacy,” and it changes how you communicate with your clients.

Defining Health Literacy
Health literacy, as defined by the Patient Protection and Affordable Care Act of 2010, is “the degree to which an individual can obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.”2 The National Assessment of Adult Literacy (NAAL) reported that “just 12% of Americans possess competent health literacy skills.”3

Health literacy is not the same as illiteracy, but they are often related. People who read well and are comfortable using numbers can experience health literacy issues, and the CDC provides a list of these situations:3

  • They aren’t familiar with medical terms or how their bodies work.
  • They have to interpret numbers and evaluate risks that affect their health and safety.
  • They are diagnosed with a serious illness and are scared and confused.
  • They have health conditions that require complicated self-care.
medicine bottle
A label on a pill vial may not be enough communication. It is the role of every team member at the veterinary practice to make an effort to recognize warning signs of low health literacy and provide clear communications to help the client make informed decisions.
Health Literacy in Veterinary Care
Although the aforementioned situations are written as they relate to humans dealing with personal health concerns, it is easy enough to see these situations in every veterinary hospital exam room. How often do you see clients unfamiliar with medical terms or how their dog or cat’s body works? Can all your clients evaluate the risks and benefits affecting their pet’s health? When you deliver a serious diagnosis, do any of your clients become scared and confused? How great is client compliance when the pet’s condition requires complicated at-home care?

Health literacy problems extend beyond human healthcare and into veterinary healthcare—and the veterinary team needs to be aware of its existence and take steps to take to overcome the barrier.

Consider the following prescription label: “Give 2 tablets twice daily for 14 days; Give 1 tablet today, 2 tablets tomorrow, then 3 tablets daily until finished.” It sounds like typical labels for any medication dispensed to treat a pet’s condition, right? However, in a study of human patients receiving a group of labels as examples for their medication, forty-six percent did not understand the instructions, and 38% with adequate literacy skills missed at least one label.1

Now think about your clients and what they could miss on their pets’ prescription bottles. A label on a pill vial may not be enough communication. It is the role of every team member at the veterinary practice to make an effort to recognize warning signs of low health literacy and provide clear communications to help the client make informed decisions.

Avoid questions such as, “Do you understand?” or “Do you have any questions?” because these types of questions are too easy to give a quick yes/no reply to.1 Instead, use teach-back techniques to ensure the client understands the instructions. Phrases such as, “I want to make sure I have explained your pet’s medicine clearly,” or “Can you tell me how you think you will give this medicine to your pet?”

Enable your team to check if the client heard what they said. In addition to confirming the client heard/understood what was said, the veterinary team can ensure they address the client’s needs.

Meeting Your Clients’ Wants and Needs
Do you know what your clients want or need? Chances are your clients wants and needs are a mystery to you. The best way to find out is to ask—and one way to ask a large number of your clients is to conduct a survey.
The over-arching purpose of conducting client surveys is for you to have an opportunity to hear from your own clients. You will gain insights into their wants and needs and build your relationship with your clients by changing what services you provide and how you communicate with them.

Surveys conducted face-to-face or through email, text message, phone call or social media are great ways to collect information from your clients. You may want to use one method for one point of focus (i.e., medical care received) and a different approach for a different focus (i.e., ease of doing business with your hospital). Examples of client survey methods include:

  • NET PROMOTER SCORE (NPS): “How likely are you to recommend us to your friends and family?” Sounds simple enough—ask a single question, get an easy reply.
  • CUSTOMER EFFORT SCORE (CES): “How difficult was it for you to schedule an appointment with us?” This is another single-question survey designed to tell you about the client’s effort to schedule an appointment to see you.
  • CUSTOMER SATISFACTION SCORE (CSAT): “How would you rate your overall satisfaction with the service you received?” This question measures client satisfaction with services they received on a 0-100% satisfaction scale.
  • FOCUS GROUP: A focus group is a way for your practice to get feedback, gather ideas and suggestions, and hear about client needs from those who use your services. It would be best to have a clear purpose for the group and a good mix of participants.

Be sure to communicate your survey intentions to your clients by promoting the survey on your website, sending an email or text message survey link to your client after their visit, or providing a QR code on their invoice to link them to a survey. Then you can gather the responses, identify improvement opportunities, implement changes and monitor the results.

The over-arching purpose of conducting client surveys is for you to have an opportunity to hear from your clients. You will gain insights into their wants and needs and build your relationship with your clients by changing what services you provide and how you communicate with them.

The Changing Face of Communication
From patient intake to medical services, the digital transformation has changed how veterinary teams interact with clients and provide medical care to pets. One example is the shift from paper to digital forms.

Many veterinary hospitals have forms to complete upon arrival, but no one gave them a second thought until curbside services presented the challenge for the customer service team to get the documents to and from clients sitting in their cars. Even if the forms were available for download from the hospital website, the failure of clients to remember to bring the form to the appointment or the inability to print a hard copy had to be resolved. Online intake forms presented an easy and efficient way for the client to complete the form at their convenience; hit submit and quickly give the customer service team everything they needed.

No one will miss dealing with a clipboard and paper forms, waiting for a client to complete the paperwork (while trying to control the pet) or spending time transferring information from paper to the electronic medical record. Instead, efficiency in that area allows more time to talk to the client and get to know the pet—whether in the exam room or through a virtual visit.

Speaking of virtual visits, your team’s communication with your clients can be enhanced with the use of virtual care teams. Not only do these teams conduct virtual exam visits, but there are also team members monitoring data from wearable devices and communicating with clients. Instead of delaying an in-office visit, patients can be seen more quickly in virtual exam rooms.

Electronic medical records were just the beginning of connecting clients, primary care DVMs and specialists; wearable devices and asynchronous communications expand the opportunity to monitor patients and provide care outside the walls of the hospital exam room. Digital tools make it more convenient to do business with your team and improve access to care and communication between everyone caring for a pet.

The impact of all the necessary and creative changes undertaken by veterinary practices will continue well into the future. The pandemic exposed weaknesses in the veterinary business model and provided opportunities to pivot and reimagine how the veterinary team communicates with clients and provides patient care. With these improvemnents in client communication, the veterinary team can help break down clients’ health literacy barriers and provide better care to pets.

References:

  1. Davis, T. Health Literacy: Hidden Barriers and Practical Strategies. Agency for Healthcare Research and Quality. U.S. Department of Health & Human Services. https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/tool3a/index.html
  2. Health Literacy. Centers for Disease Control and Prevention. https://www.cdc.gov/healthliteracy/index.html
  3. Understanding Health Literacy. Centers for Disease Control and Prevention. https://www.cdc.gov/healthliteracy/learn/Understanding.html
Louise Dunn headshot
Louise Dunn is a renowned award-winning speaker, writer and consultant. She brings over 40 years of in-the-trenches experience and her business education to veterinary management. Louise is founder and CEO of Snowgoose Veterinary Management Consulting. SVMC works with veterinarians who want to develop a strategic plan that consistently produces results. Most recently Louise received many awards including the WVC Educator of the Year numerous times and VetPartner’s The Life Time achievement Award in January 2016.
Back to Issue