Ask Me 3 and Ask 3 Questions

According to the Scottish Government, difficulties with reading, writing and numbers can affect people's health and their ability to find, understand and apply health information.

Ask Me 3 and the Ask 3 Questions campaign can help to improve health communication between patients and health professionals by encouraging the patient to ask three questions during each visit. Both techniques are quick, effective and easy to implement and are being used across NHSScotland.

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How to do it

Ask Me 3, developed by the Link opens in a new windowNational Patient Safety Foundation, encourages people to ask their health professional (doctor, nurse, pharmacist and other providers) the following questions at the end of every health appointment or consultation, when preparing for a medical test or procedure or when picking up medicine:

  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?

First and foremost, it is important to raise awareness of this initiative with staff prior to its implementation. It is also important to raise patient awareness of the benefits of asking the above three questions. Healthcare staff should use every opportunity to chat to patients about this initiative and to encourage them to ask these three questions at the end of their consultations. This could be carried out when patients are waiting for their appointment or when they arrive at the reception desk.

To help promote Ask Me 3, there are many free materials available to download from the Link opens in a new windowNational Patient Safety Foundation’s website, including brochures and posters. There is also a DVD available which could be used within waiting areas. It is important, however, to be mindful that continuous playing of a DVD may become irritating to patients and reception staff, particularly if it is a small waiting area. Whilst the patient is waiting to be seen they should be provided with a pre-printed ‘Ask Me 3 form’ which they will take into their consultation and use to write down the answers to the three questions. However, some patients may find this daunting especially if they have writing problems and alternative methods should therefore be explored and offered. For instance, the health professional could offer to tape the answers.

The Ask 3 Questions campaign aims to help patients and service users to get the support they need to make informed decisions about their health and care. It is based on research from Cardiff University and the Health Foundation and encourages patients to ask three key questions:

  • What are my options?
  • What are the pros and cons of each option for me?
  • How do I get support to help me make a decision that is right for me?

Whilst both Ask Me 3 and Ask 3 Questions focus on the patient asking the questions, it is important that the health professional is able to provide answers that the patient will understand.

Top Tips to Aid Understanding

  • Sit down with the patient (instead of standing) to maintain eye level.
  • Use plain language.
  • Use simple vocabulary and avoid technical words or jargon. If you need to use a technical word, this must be followed by a definition.
  • Use pictures, illustrations or visual models to illustrate a procedure.
  • Avoid acronyms, but if you must use one, explain its meaning when it is first used.
  • Use the teach-back technique which encourages the health professional to ask the patient to repeat back his or her understanding of what they have just been told.

Pros

  • Quick and effective
  • Not expensive to use
  • Easy to implement
  • Can help to raise awareness of health literacy challenges among patients and staff
  • Both techniques help patients to have a better understanding of their health, encourage them to get involved in managing their own healthcare and improve communication between patients and health professionals.
  • By writing down their answers, patients will have a record of their conversation with their health professional. However, health professionals should be mindful that some patients may have difficulties with writing things down and this alone may discourage them to ask the questions.

Cons

  • Both techniques require buy-in from the health professional as well as from patients
  • Patients need to take notes and, although this would work for some, it could be challenging for people with literacy issues or learning disabilities
  • It can require time, though it does not increase appointment length significantly.
  • As time is often limited during medical appointments and examinations patients may feel reluctant to ask questions. As a result, it may be difficult for the health professional to gauge what the patient does not understand.
  • There are some doubts as to its effectiveness when Ask Me 3 is used as a standalone tool. Many resources suggest using it in conjunction with the teach-back technique.

Resources

Top Tips

  • Patients may wish to take a friend with them to their consultation.
  • Always assume that the patient does not understand what you are saying or has a different perception of what you are saying.
  • Health professionals should encourage patients to ask questions, and should structure the information they provide to patients around these questions.
  • Health professionals should be encouraged to learn more about low health literacy and to broaden their knowledge of health literacy issues.
  • For some non-English speaking patients, translators can be provided by the healthcare organisation to assist with communication between the patient and health professional.

Sources and Further Information