Care Experience Lab · Leadership Diagnostic
Healthcare Communication Clarity Assessment
A practical, scored self-assessment that helps healthcare leaders evaluate how understandable, usable, and patient-centered their organization’s communication really is — and turn the results into a focused improvement plan.
Self-Assessment
Consulting Diagnostic
Workshop Exercise
Annual Re-assessment
Consulting Diagnostic
Workshop Exercise
Annual Re-assessment
Version 1.0 · 50 questions · 10 categories · 5-point maturity scale
Purpose
Clear communication is one of the most powerful and most overlooked drivers of patient experience, safety, equity, and trust. When patients and families understand what is happening, what to do, and why it matters, outcomes improve and avoidable harm and confusion go down. Yet most organizations have never systematically evaluated how clear their communication actually is across the entire patient journey.
This assessment gives leaders a structured way to do exactly that. It is designed to function as four tools in one:
- A leadership self-assessment — a quick, honest baseline of where your organization stands today.
- A consulting diagnostic — a defensible, category-by-category view of strengths and gaps.
- A workshop exercise — a shared scoring activity that builds alignment across a leadership team.
- A repeatable annual assessment — a way to track measurable progress year over year.
Instructions
- Define your scope. Decide whether you are assessing a unit, a service line, a facility, or the whole organization. Keep the scope consistent for every question.
- Choose your respondents. For a self-assessment, one leader can complete it. For a stronger result, have 3–8 leaders score independently, then compare and discuss differences.
- Score each question 1–5 using the maturity scale below. Score what is actually and consistently true today — not what is aspirational, occasional, or written in a policy but not practiced.
- Total each category (max 25 per category) and record it on the scoring sheet.
- Add category totals for an overall score out of 250.
- Interpret your results using the scoring and priority sections, then complete the action plan and 90-day worksheet.
- Re-assess annually (or after a major improvement effort) to measure progress.
Tip: When scores differ across respondents, the conversation about why is often more valuable than the number itself. Treat disagreement as data.
Communication Maturity Model
Every question is scored on the same five-point maturity scale. Use these definitions consistently.
| Score | Maturity Level | What it looks like |
|---|---|---|
| 1 | Not Started | No defined approach. Practice is absent, unknown, or left entirely to individuals. |
| 2 | Emerging | Early, inconsistent efforts. Some awareness or pilots exist, but no standard or spread. |
| 3 | Developing | A standard exists and is used in parts of the organization, but adoption is uneven. |
| 4 | Established | A clear standard is consistently applied and monitored across most of the scope. |
| 5 | Leading Practice | Consistent, measured, continuously improved, and embedded in culture. Others could learn from you. |
The 50 Assessment Questions
Ten categories, five questions each. Circle or record a score of 1–5 for every statement, then total each category.
1Leadership Commitment
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Clear, understandable communication is named as a priority in our strategic or experience goals, with an executive sponsor accountable for it. | 1 2 3 4 5 |
| 2 | Leaders allocate budget, staff time, or tools specifically to improving communication clarity and health literacy. | 1 2 3 4 5 |
| 3 | Communication clarity is a standing item leaders review (e.g., in operations, quality, or experience meetings) rather than a one-time project. | 1 2 3 4 5 |
| 4 | Leaders model plain-language communication themselves in messages, rounding, and town halls. | 1 2 3 4 5 |
| 5 | Improving communication clarity is explicitly tied to outcomes leaders care about (safety events, readmissions, CAHPS, equity, complaints). | 1 2 3 4 5 |
| Category 1 subtotal (max 25) | _____ / 25 | |
2Organizational Health Literacy
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | We have an organization-wide standard or policy that materials and instructions be written at a plain-language reading level (commonly 5th–8th grade). | 1 2 3 4 5 |
| 2 | Staff are trained to use universal precautions for health literacy (assume everyone may struggle, and confirm understanding). | 1 2 3 4 5 |
| 3 | We use teach-back as a routine, expected practice to confirm patient understanding. | 1 2 3 4 5 |
| 4 | Key materials are reviewed with patients or a patient/family advisory group before release. | 1 2 3 4 5 |
| 5 | We track at least one measure related to patient understanding (e.g., teach-back use, comprehension survey items, callback questions). | 1 2 3 4 5 |
| Category 2 subtotal (max 25) | _____ / 25 | |
3Written Communication
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Patient-facing letters, forms, and instructions are written in plain language and reviewed for readability before use. | 1 2 3 4 5 |
| 2 | Documents use clear headings, short sentences, bulleting, and adequate white space rather than dense text. | 1 2 3 4 5 |
| 3 | We avoid or clearly define medical jargon, abbreviations, and acronyms in patient-facing materials. | 1 2 3 4 5 |
| 4 | Visuals, icons, or illustrations are used to support understanding where helpful. | 1 2 3 4 5 |
| 5 | We maintain a controlled, current library of approved patient materials so outdated or off-brand documents are not in circulation. | 1 2 3 4 5 |
| Category 3 subtotal (max 25) | _____ / 25 | |
4Verbal Communication
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Staff are trained in specific verbal communication skills (e.g., warm greetings, plain language, teach-back, empathy statements). | 1 2 3 4 5 |
| 2 | Clinicians routinely confirm understanding before ending an encounter rather than asking only ‘Do you have any questions?’ | 1 2 3 4 5 |
| 3 | Staff slow down, avoid jargon, and check for understanding with patients who appear confused or overwhelmed. | 1 2 3 4 5 |
| 4 | We have a consistent approach to communicating difficult news and sensitive information. | 1 2 3 4 5 |
| 5 | Verbal communication skills are observed and coached (e.g., through rounding, shadowing, or simulation), not just taught once. | 1 2 3 4 5 |
| Category 4 subtotal (max 25) | _____ / 25 | |
5Digital Communication
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Our patient portal, website, and digital messages are written in plain language and are easy to navigate. | 1 2 3 4 5 |
| 2 | Appointment reminders, results, and digital instructions clearly tell patients what to do next and who to contact. | 1 2 3 4 5 |
| 3 | Digital tools (portal, forms, kiosks) are usable by people with limited digital or health literacy, with support available. | 1 2 3 4 5 |
| 4 | Automated and templated digital messages are reviewed for clarity and tone, not just accuracy. | 1 2 3 4 5 |
| 5 | We monitor digital communication for understandability (e.g., portal message readability, support-line questions, drop-off points). | 1 2 3 4 5 |
| Category 5 subtotal (max 25) | _____ / 25 | |
6Patient & Family Education
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Education is tailored to the individual’s needs, language, and literacy level rather than handed out as a one-size-fits-all packet. | 1 2 3 4 5 |
| 2 | We confirm understanding of education using teach-back and document the result. | 1 2 3 4 5 |
| 3 | Families and caregivers are intentionally included in education when appropriate to the patient. | 1 2 3 4 5 |
| 4 | Education reinforces the most important ‘need-to-know’ points first, rather than overwhelming patients with everything at once. | 1 2 3 4 5 |
| 5 | Education materials and methods are available in the languages and formats our patient population needs. | 1 2 3 4 5 |
| Category 6 subtotal (max 25) | _____ / 25 | |
7Care Transitions & Discharge
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Discharge instructions clearly state what to do, what to watch for, what medications to take, and who to call — in plain language. | 1 2 3 4 5 |
| 2 | We use teach-back to confirm the patient and caregiver understand the discharge plan before they leave. | 1 2 3 4 5 |
| 3 | Follow-up appointments, referrals, and next steps are communicated clearly and confirmed, not just listed. | 1 2 3 4 5 |
| 4 | Warning signs and ‘what to do if things get worse’ instructions are explicit and easy to find. | 1 2 3 4 5 |
| 5 | We communicate clearly with the next care setting (e.g., primary care, home health, SNF) during transitions. | 1 2 3 4 5 |
| Category 7 subtotal (max 25) | _____ / 25 | |
8Accessibility & Inclusion
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Qualified medical interpreters and translated materials are readily available and used for patients with limited English proficiency. | 1 2 3 4 5 |
| 2 | We provide accommodations for patients with vision, hearing, cognitive, or communication disabilities. | 1 2 3 4 5 |
| 3 | Communication is adapted for diverse cultural backgrounds and health beliefs in a respectful way. | 1 2 3 4 5 |
| 4 | Digital and physical materials meet recognized accessibility standards (e.g., readable fonts, contrast, alt text, navigability). | 1 2 3 4 5 |
| 5 | We review communication practices specifically for equity gaps across populations we serve. | 1 2 3 4 5 |
| Category 8 subtotal (max 25) | _____ / 25 | |
9Measurement & Continuous Improvement
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | We collect data on communication clarity (e.g., relevant CAHPS/HCAHPS items, teach-back rates, complaints, comprehension checks). | 1 2 3 4 5 |
| 2 | Communication data is reviewed regularly and segmented to find specific gaps (by unit, population, or step in the journey). | 1 2 3 4 5 |
| 3 | We run improvement cycles on communication and can point to changes made because of the data. | 1 2 3 4 5 |
| 4 | Patient and family feedback directly informs revisions to materials and practices. | 1 2 3 4 5 |
| 5 | We can demonstrate measurable improvement in communication over time. | 1 2 3 4 5 |
| Category 9 subtotal (max 25) | _____ / 25 | |
10Culture & Accountability
| # | Statement — score how consistently true this is today | Score |
|---|---|---|
| 1 | Clear communication is treated as everyone’s responsibility, not just a marketing, education, or experience department task. | 1 2 3 4 5 |
| 2 | Expectations for clear communication are built into onboarding, role expectations, and ongoing training. | 1 2 3 4 5 |
| 3 | Staff feel safe to speak up when materials or instructions are confusing, and those concerns lead to fixes. | 1 2 3 4 5 |
| 4 | We recognize and reinforce excellent communication (e.g., recognition, sharing exemplars, coaching). | 1 2 3 4 5 |
| 5 | Accountability for communication clarity is clear — people know who owns it and how it is monitored. | 1 2 3 4 5 |
| Category 10 subtotal (max 25) | _____ / 25 | |
Scoring Guide
Record each category subtotal (max 25), then add them for your total (max 250). Use the scoring sheet below.
| Category | Subtotal | Avg (÷5) |
|---|---|---|
| 1. Leadership Commitment | _____ / 25 | _____ |
| 2. Organizational Health Literacy | _____ / 25 | _____ |
| 3. Written Communication | _____ / 25 | _____ |
| 4. Verbal Communication | _____ / 25 | _____ |
| 5. Digital Communication | _____ / 25 | _____ |
| 6. Patient & Family Education | _____ / 25 | _____ |
| 7. Care Transitions & Discharge | _____ / 25 | _____ |
| 8. Accessibility & Inclusion | _____ / 25 | _____ |
| 9. Measurement & Continuous Improvement | _____ / 25 | _____ |
| 10. Culture & Accountability | _____ / 25 | _____ |
| TOTAL | _____ / 250 |
Two lenses, both useful: The total score shows overall maturity. The category averages show where to focus — a low category average points to a specific, fixable gap even when the total looks healthy.
Score Interpretation
| Total | Overall Maturity | What it means |
|---|---|---|
| 50–99 | Not Started / Emerging | Communication clarity is largely left to individuals. High risk of confusion, avoidable harm, and inequity. Start with leadership commitment and a few high-impact basics. |
| 100–149 | Developing | Pockets of good practice exist but are inconsistent. The opportunity is to set standards and spread what already works. |
| 150–199 | Established | Clear communication is a consistent, monitored standard across most areas. Focus on closing remaining gaps and tightening measurement. |
| 200–250 | Leading Practice | Clarity is embedded, measured, and continuously improved. Sustain it, protect it during change, and share your model with others. |
A single low category (average ≤ 2) deserves attention even with a strong total — it usually marks where patients are most at risk of misunderstanding.
Priority Matrix
Not every gap deserves the same urgency. Plot your lowest-scoring categories on this matrix to decide what to tackle first. Estimate each category’s impact on patients (risk of harm, confusion, or inequity if it stays as-is) and your effort to improve it.
| Lower Effort | Higher Effort | |
|---|---|---|
| Higher Patient Impact | DO FIRST — Quick Wins High value, fast. Start here this quarter. | PLAN — Major Priorities Worth it, but needs resourcing and a roadmap. |
| Lower Patient Impact | EASY GAINS — Fill In Do when capacity allows; low risk if delayed. | DEFER — Reconsider Don’t over-invest here yet; revisit later. |
Record your placements:
| Lowest-scoring category | Impact (H/M/L) | Effort (H/M/L) | Quadrant |
|---|---|---|---|
| ________________________ | ______ | ______ | ______ |
| ________________________ | ______ | ______ | ______ |
| ________________________ | ______ | ______ | ______ |
Immediate Action Plan
Translate your results into a short, concrete summary. Complete this immediately after scoring while the discussion is fresh.
| Top 3 strengths (highest categories) | 1. ____________________________ 2. ____________________________ 3. ____________________________ |
| Top 3 priorities (lowest categories) | 1. ____________________________ 2. ____________________________ 3. ____________________________ |
| Recommended next actions | 1. ____________________________ 2. ____________________________ 3. ____________________________ |
| Executive sponsor | ____________________________ |
| Re-assessment date | ____________________________ |
90-Day Improvement Worksheet
Pick one or two priorities from your matrix and turn them into a focused 90-day plan. Keep it small enough to finish — momentum matters more than scope.
| Window | Focus & example actions | Owner | Success measure |
|---|---|---|---|
| Days 1–30 | Align & baseline. Confirm sponsor and priority; brief the team; set the baseline measure; pick one or two specific changes. ____________________________ | ____________ | ____________ |
| Days 31–60 | Pilot & coach. Test the change in one area; train and coach staff; gather quick feedback; adjust. ____________________________ | ____________ | ____________ |
| Days 61–90 | Spread & measure. Standardize what worked; expand to more areas; re-measure against baseline; report results to the sponsor. ____________________________ | ____________ | ____________ |
| Baseline measure & value | ____________________________ |
| 90-day target | ____________________________ |
| Review date & next step | ____________________________ |
References & Further Reading
These are established, reputable sources on health literacy and clear communication. Guidelines, tools, and URLs are updated periodically — please verify the current version and link at the time of use.
- Agency for Healthcare Research and Quality (AHRQ). Health Literacy Universal Precautions Toolkit. Includes guidance on teach-back and plain-language communication. (ahrq.gov)
- U.S. Department of Health and Human Services. Healthy People — Health Literacy (organizational and personal health literacy definitions and objectives). (health.gov)
- Centers for Disease Control and Prevention (CDC). Clear Communication Index and plain-language resources. (cdc.gov)
- Centers for Medicare & Medicaid Services (CMS). Toolkit for Making Written Material Clear and Effective. (cms.gov)
- The Joint Commission. “What Did the Doctor Say?”: Improving Health Literacy to Protect Patient Safety and related communication standards. (jointcommission.org)
- National Institutes of Health (NIH) / National Library of Medicine. Clear & Simple guidance for developing easy-to-read materials. (nih.gov)
- Institute for Healthcare Improvement (IHI). Resources on teach-back and patient/family communication. (ihi.org)
- plainlanguage.gov. Federal Plain Language Guidelines. (plainlanguage.gov)
- CAHPS® / HCAHPS® survey materials for communication-related measures (cahps.ahrq.gov; hcahpsonline.org).
- Web Content Accessibility Guidelines (WCAG), W3C, for digital accessibility standards. (w3.org/WAI)
Related Care Experience Lab Resources
- Health Literacy & Plain Language Transformation Toolkit — deeper tools to act on gaps found in this assessment.
- Hospital & Home Health CAHPS Leadership Toolkit — connect communication clarity to your CAHPS results.
- Leader Rounding Question Cards — a printable Quick Win for stronger verbal communication and rounding.
- Patient Journey Mapping & Experience Design Toolkit — map where communication breakdowns occur across the journey.
How to use this assessment: Score honestly against what is consistently true today, prioritize with the matrix, and commit to one or two focused 90-day improvements. Re-assess annually to measure progress. This resource is provided for general improvement purposes and is not legal, regulatory, or clinical advice; adapt it to your organization’s policies and the populations you serve.
Recommended Next Resource
Hospital & Home Health CAHPS Leadership Toolkit →
Turn communication clarity into better CAHPS performance.