Questions? Ask me 3!

In a previous blog “Why Didn’t They Say it Like That? Health Literacy,” I gave a general overview of Health Literacy and some steps that we, as nurses, can take to address the issues of low health literacy in our day-to-day practice. In this blog I would like to take a more in-depth look at one way to engage our patients to become more active and engaged partners in their health care.

The ideal time to educate patients on becoming informed consumers of health care is when he or she is healthy and ther
e are no immediate concerns to address. Nurses often interact with patients when a concern about some aspect of his or her health comes up. It may be an acute or chronic condition, and it is apparent to us as clinicians that further treatment is necessary. Many times there is more than one treatment option available and the patient looks to the clinician for guidance on what to do.

Using the Ask Me 3 concept developed by the National Patient Safety Foundation(NPSF) is a way that we can educate our patients when they are healthy, as well as when there is a health care need that must be addressed. The concept is simple, three questions that the patient should ask each time they have an appointment or hospitalization. The three questions are:

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

’s look at each of these questions in more detail.

What is my main problem? Patients are often unable to understand and process multiple items at one time; and when there are numerous health conditions in play, this complexity becomes even more overwhelming. The clinician needs to assess the situation and prioritize how to work with the patient. For example, if a patient comes in with a blood glucose of 200 and a blood pressure of 140/90 both items will need to be managed, but the blood glucose is what is most concerning at that moment. By narrowing the focus to one problem we increase the chances of the patient understanding the concern. Patients that understand their health issues are less likely to make mistakes when they take their medicine and care for themselves at home.

What do I need to do? Here is the chance to revisit any education that has already occurred and put it in simple terms the patient is more likely to understand. Include any visual aids that are available including pictures and videos. Ensure that all of your teaching materials are also available in other languages. Encourage patients to ask this question during each interaction with health care staff so that they receive the necessary repetition and guidance.

Why is it important for me to do this? When the patient asks this question, clinicians have another chance to reinforce why the patient needs to be an active participant in taking care of themselves once they are at home. Again, answers to this question should be put in simple terms the patient understands. “It is important for you to walk after surgery to help you heal quickly and without complications. I know you don’t have a lot of energy right now, so short walks to around the house are fine. Try to do this 5 times a day.”

There a multiple ways to implement Ask Me 3; educating staff, posting materials in waiting and exam rooms, and discussing Ask Me 3 with patients and families. The National Patient Safety Foundation (NPSF) has many complimentary resources and materials available to assist you in getting started. You can find more information on their website at

Patients are sometimes embarrassed to ask questions. By creating an environment where questions are encouraged patients are more likely to be active participants in their health care, less likely to make mistakes when caring for themselves, have positive outcomes, and increased patient satisfaction.

Questions? Ask Me 3!

Christina Salm

Christina is a registered nurse who has practiced in a wide variety of settings from rural, critical access hospitals, to academic, acute care facilities, hospice, case management, and healthcare insurance operations. This diverse background has set Christina’s course as a leader in advancing positive change for clinicians. Her work has led to awards such as the MCG Doyle Award for Healthcare leadership and innovation. She is passionate about the role of nursing as patient advocates, health literacy and navigating the healthcare system. Her philosophy is that nurses have a unique role acting as translators to advance patient’s understanding of what they need to do to be well and clinicians understanding of what is most important to the patient and how that influences his/her health.

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