Brigham and Women's Hospitals

Pal Care Ask Tell Ask

Ask-Tell-Ask for Assessing Understanding and Delivering Information

Step

What you might say

Rationale

  1. ASK – what the patient and family already understand

“Tell me what you’ve heard so far about where things are at with your illness?”

  • Always start by clarifying what the patient/family already know
  • Helps you know where to start from in the conversation
  • Saves you time – helps avoid a detailed “medical update” when it’s not needed
  1. TELL – new information in a straight-forward way

HINT: Give a Headline

The headline is the key piece of information they need to know.

“Your mother’s condition has worsened. I’m worried she may not survive this illness.”

HINT: The headline here is: “I’m worried she may not survive this Illness.”

  • Speaking in a clear, straight-forward way and avoiding jargon will help patients/families take in new information
  • Avoid long, detailed explanations
  • Expect emotion after giving news (employ NURSE statements above)
  1. ASK – what the patient and family are taking-away

OR…

ASK – for permission to talk more

“To make sure I was clear, can you tell me what you’re taking away from our conversation?”

OR…

“Given what you’ve heard, could we talk about where we go from here?”

  • Helps you know what the patient and family heard
  • Provides opportunity for patient/ family to ask questions and clarify information

  • Helps you know if the patient/family are ready to talk about next steps
  • Helps transition conversation to talk about goals and next steps in care