Wisconsin Collaborative for Quality Healthcare

Improving Patient-Provider Communication


The Wisconsin Collaborative for Healthcare Quality (WCHQ) partnered with the Wisconsin Department of Health Services and other organizations to test the effectiveness of an education program designed to improve patient-provider communication, help patients understand health instructions, and engage patients in their own healthcare.

The program, known as Ask Me 3™, encourages patients to ask three questions during each healthcare visit:

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

The pilot program compared two different implementation approaches, low-intensity and enhanced, among racially and ethnically diverse, low-income patient populations.

Under the low-intensity approach, print materials were placed in easily accessible locations throughout the centers and a brief orientation session was held for all center staff in advance of launching the program. A four minute DVD played on a continuous loop in the main waiting area to emphasize the importance of patients asking questions and demonstrating how individuals might use the questions in their visit.

The enhanced approach included all of the activities described in the low-intensity approach. In addition, all clinical staff, doctors, physician assistants, and nurse practitioners received training on four simple, evidence-based approaches for communicating with their patients. At one of these sites, customer service representatives also spoke individually in the waiting area with patients about the program and encouraged them to ask their provider the three questions.

The evaluation, conducted by the Wisconsin Department of Health Services, suggests that the simple, low-intensity approach did not affect patient satisfaction or engagement, nor did it appear to motivate patients to ask their healthcare provider questions. The enhanced approach did appear to lead patients to have higher expectations of their provider and how they communicate. The evaluation also found that both patients and providers may need additional training and encouragement to significantly improve communication and get patients more engaged in their care. The findings suggest that Ask Me 3 may increase expectations for improved communication, but by itself was not enough to motivate patients to ask questions. The findings also suggest patients value having someone speak directly about the importance of understanding what their doctor is telling them. The program was successful in raising awareness about health literacy and the importance of clear communication, which may increase staff readiness for more intensive programs.

WCHQ and the Wisconsin Department of Health Services conducted the pilot program at six community health centers with the support of the Wisconsin Medical Society, Wisconsin Literacy, Wisconsin Primary Health Care Association, Southwest Wisconsin Area Health Education Center, University of Wisconsin-Madison—Population Health Institute, University of Wisconsin-Madison—Department of Family Medicine, and the Wisconsin Research and Education Network.

For additional information on the Wisconsin-based Ask Me 3 program, please contact Cindy Schlough with WCHQ (cschlough@wchq.org; 608.826.6839) or Linda McCart with the Wisconsin Department of Health Services (linda.mccart@wi.gov; 608.266.9296).

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