Caceres Jennifer W, Alter Scott M, Shih Richard D, Fernandez Jimmy D, Williams Frederick K, Paley Richard, Benda William, Clayton Lisa M
From the Department of Integrated Medical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Expansion Markets, San Antonio, Texas, the University of Miami/JFK Medical Center Palm Beach Regional GME Consortium, Atlantis, Florida, and St Mary's Medical Center, West Palm Beach, Florida.
South Med J. 2017 May;110(5):359-362. doi: 10.14423/SMJ.0000000000000642.
Patients are 30% less likely to be readmitted or visit the emergency department if they have a clear understanding of their discharge instructions. A standardized approach to a hospital discharge plan has not been universally implemented, however. Our goal was to increase patients' comprehension of discharge instructions by implementing a standardized patient-centered discharge planning protocol that uses a physician team member to explain these plans.
This was a prospective study that included all of the patients discharged from an inpatient medical teaching service in a community-based hospital during the study period. We used two 4-week periods separated by 4 months in which training and practice with the study intervention took place. Patients' understanding of discharge instructions was assessed via a follow-up telephone call from a physician co-investigator within 1 week of each patient's discharge. Differences in patients' understanding between groups were analyzed.
A total of 181 patients were enrolled, with 9 lost to follow-up. After implementation of the discharge planning protocol, a statistically significant improvement in patients' understanding was found in study subjects' knowledge of their diagnosis, the adverse effects of their medications, whom to call after discharge, and follow-up appointments.
Institution of a standardized patient-centered discharge planning protocol can improve patients' understanding of several key components of their discharge process, which may lead to improved compliance with instructions and outcomes.
