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. Here are some tips about how to communicate more clearly.

• Choose only those acronyms and abbreviations that benefit the other person, not just you. For instance, there may be no need to introduce an acronym if you use the term only once. For instance, does your audience really need to know that the acronym for “National Institutes of Health” is “NIH”? Maybe yes, maybe no. My recommendation is that you make choices about acronyms based on what matters to the audience. 
• If an acronym is really needed, help by explaining its meaning. Put either the acronym or full term in parentheses alongside the other, such as “BP (blood pressure).” While some editors may disagree, for the sake of clarity and understanding I recommend deciding in each instance whether to put the full form of the word or its acronym first. I tend to write the most commonly-used term first, and then either the acronym or full wording. Readers might sometimes benefit from a clear explanation rather than the acronym spelled out. For instance, “IV (a needle that goes into your arm).” 
• Provide context to help readers determine which acronym you mean. Acronyms can have different meanings depending on where and how they are used. For example, “AAA” can stand for the American Automobile Association, the Area Agency on Aging, or an aortic abdominal aneurysm. 
• Be aware of pronunciation. Acronyms and initialisms are pronounced differently. For example, “HIPAA” (Health Insurance Portability and Accountability Act) is an acronym and pronounced as a single word. But “CHF” (congestive heart failure) is an initialism and pronounced as three distinct letters. 
• Write out full directions rather than abbreviations. This is particularly important for dosing instructions. While clinicians know the meaning of terms such as QD or SID (once a day), QOD or EOD (every other day), BID (twice a day), and TID (three times a day), patients may not. Clearly explain what to do, giving instructions like “Take this pill two times a day—one pill at breakfast and one pill at dinner time.” It can help even more to specify the time, such as “8:00 in the morning and 6:00 at night.” 

 More ways to learn:

• Health Literacy Out Loud podcast interview with Dean Schillinger, MD. “Talking About Jargon (HLOL #94).”
• Osborne H. (2008). “Abbreviations, acronyms, and other healthcare shorthand. In other words,” On Call Magazine. Archived at http://www.healthliteracy.com/abbreviations-acronyms

This month’s How-To Tip is adapted from the “Jargon, Acronyms, and Other Troublesome Words” chapter in Helen Osborne’s book, Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Third Edition.