Rx for Patient Safety: Ask Me 3

Victoria H. Rollins, MHA, RN, Director, Patient Safety Programs.

It makes sense that people with a clear understanding of health instructions will make fewer errors when taking medications and that they are better prepared to manage their own health outcomes.

In the precious few moments a physician has with a patient, clear communication can be an extraordinary challenge. It is common for patients to nod their heads as an indication that they understand what the physician is saying. However, they sometimes leave the physician’s office and tell a friend or family member they “did not understand a word that was said.”

What happens during the patient-physician communication? Research has shown that most physicians interrupt the patient 22 seconds after he or she begins speaking. When given the opportunity to speak, however, most patients will only talk for about two minutes. Frequent interruptions and distractions may result in unclear and imprecise communications between the physician and the patient.

To promote clear communication, the Institute for Healthcare Improvement/National Patient Safety Foundation offers a patient education program called “Ask Me 3.” Educational materials to implement the Ask Me 3 program may be downloaded free on the Institute for Healthcare Improvement website. Additional information available on the site includes a white paper, research studies, and other resources.

The Ask Me 3 program is a time-efficient, effective tool that encourages the patient to participate in his or her own healthcare by understanding the answers to three questions:

  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

During the visit, the patient is provided with a preprinted Ask Me 3 form and instructed to write down the answers to the three questions in the presence of the physician.

It is important for the physician to have some idea of the literacy level of the patient and to maintain a safe environment so that the patient does not feel intimidated or rushed. Use everyday language, avoid medical terminology, and utilize friendly body mechanics such as being at the same eye level as the patient.

Once the patient has written the answers, the physician asks the patient to repeat back his or her understanding of the responses. The patient keeps the original copy, and the physician may choose to keep a copy in the patient’s medical record, as it is a good tool to use at the next visit.

The benefits of this unique program include the patient’s increased responsibility for his or her healthcare outcomes, a better understanding of medications (purpose, dosage, and times), documentation of the conversation in the medical record, and effective physician-patient communication that may help reduce or prevent malpractice claims.

For additional information and to view the forms, please visit ihi.org/resources/Pages/Tools/Ask-Me-3-Good-Questions-for-Your-Good-Health.aspx.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

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