PATIENT DISCHARGE INSTRUCTIONS FACTORS THAT IMPROVE PATIENT UNDERSTANDING

PATIENT DISCHARGE INSTRUCTIONS: FACTORS THAT IMPROVE PATIENT UNDERSTANDING AND COMPLIANCE Azka Afzal 1, Josh Honeyman 1, 2 1 UMKC School of Medicine, 2 Truman Medical Center INTRODUCTION • There are numerous factors that go into comprehension of discharge instructions: reading level, language spoken, time spent discussing instructions, etc. • The purpose of this study is to assess those factors that improve patient discharge instruction comprehension. METHODS • After the discharge process has been completed, medical students would administer a short anonymous written survey to patients. • Survey questions would be directed at: who provided the instructions; time spent discussing instructions, and perceived level of understanding. The survey would then again be administered the following day via telephone to assess retention of instructions. • All English speaking emergency department patients who consent to the survey during that time period will be included in the study. Only those who complete both the initial and follow up surveys will be included in the final results. • The paper surveys will have the patient’s MRN, name and best contact phone number listed. RESULTS • The majority of patients (80. 3%) reported that discharge instructions were provided by nurses. (36. 1% said they were provided by doctors. ) • Over 75% of patients felt that they understood their discharge instructions well. • Almost half reported 1 -3 minutes spent discussing discharge instructions. SUMMARY • Traditionally at discharge, the patient’s nurse will read whatever the physician has written in the discharge instruction section of the note. The physician may or may not have reviewed these same instructions with the patient. • Our hypothesis was that patients given the traditional written instruction along with verbal instructions from the physician would have better comprehension of their discharge instructions. • Our data found that the majority of patients (85. 2%) understood their discharge instructions well, although the instructions were mostly provided in 1 -3 minutes by nurses and not the physicians. CONCLUSION • Our hypothesis was proven incorrect. We found that the majority of patients reported excellent understanding of their discharge instructions, despite the instructions being mostly provided by nurses and over 1 -3 minutes. • Data presented is from the initial survey. There was not a significant difference between survey responses on the day of discharge and the next day. CREDITS/DISCLOSURE/REFERENCES Caputo, C. Comprehension of Discharge Instructions by Patients in an Urban Emergency Department. Annals of Emergency Medicine. 1993; 71 -74. Porter, S. C. Effective Discharge Communication in the Emergency Department. Annals of Emergency Medicine. 2012; 60: 152 -159. Engel, K. , Buckley, B. , & Forth, V. Patient Understanding of Emergency Department Discharge Instructions: Where Are Knowledge Deficits Greatest? Academic Emergency Medicine. 19; 1035 -1044.