Imagine what it’s like to be suddenly injured or ill. You or your family member calls 911. EMTs arrive and take you to the nearest ER or ED. You or someone in your family is given a lot of paperwork, including HIPAA notification. The doctors and nurses say you need an IV, MRI, EKG, and CT scan. And all this before being admitted to the ICU.
Now replay this scenario and imagine being someone who seldom, if ever, interacts with the healthcare system. Maybe you also are new to this country and speak only a limited amount of English. Not only are you dealing with pain and uncertainty, but you also must try to comprehend an unfamiliar language filled with healthcare abbreviations and acronyms.
While abbreviations and acronyms have their place as a form of shorthand, they can also lead to confusion. Based on an On Call article I wrote several years ago, here are some tips about how to communicate more clearly.
- Use abbreviations and acronyms only when you really need them. Jeanne McGee, author of the Toolkit for Making Written Material Clear and Effective, says that writers often use abbreviations and acronyms out of habit rather than as deliberate tools to improve understanding. She recommends using shortened terms only when they help. An example is using a commonly used disease name like “HIV/AIDS,” rather than “human immunodeficiency virus infection and acquired immune deficiency syndrome.” But include all words when referring to something less publicly known such as the “National Cancer Institute” rather than “NCI,” especially when using this term just once.
- Typically, introduce an abbreviation or acronym by putting it in parentheses immediately after the words it stands for. An example is “emergency department (ED).” But sometimes you need to reverse the order as in “TB (tuberculosis).” This reversal puts emphasis on the more widely-used term but still makes its meaning clear. In longer documents, McGee recommends re-defining abbreviations and acronyms at the first use in each chapter or section.
- Know what abbreviations to use, and not use. As with all technical terms, be consistent about usage. For instance, decide whether to always use “BP” or “blood pressure.” Also know what not to use. Frank Federico, of the Institute for Healthcare Improvement, suggested The Institute for Safe Medication Practice “List of Error-Prone Abbreviations, Symbols, and Dose Designations.”
- Confirm that others correctly understand your abbreviation or acronym. McGee interviewed several patients to get their reactions to an educational piece she wrote on blood glucose testing. When she asked about the terminology, one person thought that “A1c” stood for “airman first class.” Another pronounced it “alc” (as in alcoholic) in part because the font made it look more like the letter “l” rather than the numeral “1.” McGee subsequently changed the font and rewrote the term as “A-1-C,” a change that worked well for readers. As always, make sure that whatever you write and say is correctly understood by your intended audience.
More ways to learn:
- Health Literacy Out Loud podcast interview with Bridget Gaglio PhD, MPH about her experience as a patient after being hit by a car, “When Patients Create Their Own Medical Binders: A Powerful Way to Get Organized and Feel More in Control (HLOL #190).”
- Health Literacy Out Loud podcast interview with Dean Schillinger, MD. “Talking About Jargon (HLOL #94).”
- Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018). A book by Helen Osborne. Chapter 25 is about “Metaphors, Similes, and Analogies.”