Department of Urology, Mayo Clinic, Rochester, MN.
Department of Urology, Mayo Clinic, Rochester, MN.
Urology. 2021 Nov;157:201-205. doi: 10.1016/j.urology.2021.06.040. Epub 2021 Jul 22.
To assess the impact of decreasing the reading level of hospital dismissal summary information on the number of unplanned patient contacts with providers following robot-assisted radical prostatectomy.
A multidisciplinary team revised the hospital dismissal summary given to patients following prostatectomy to decrease the reading level from a 13 grade to seventh grade level. We conducted a retrospective cohort study comparing 30-day outcome measures including: patient-initiated telephone calls and online messages, unplanned clinic visits, readmission rates, and emergency department visits pre- and post-intervention. Other perioperative practices remained unchanged between the cohorts.
A total of 110 patients were included in the study (pre-intervention n=60, post-intervention n=50). Patient age (P =.72), race (P =.59), marital status (P =.39), and education level (P = 1.0) were similar between the groups. Pre-intervention, 11.7% of patients had a self-reported education lever lower than the 13 grade, compared to 2% of patients post-intervention with an education level at or below the seventh grade. Following revision of the dismissal information, the number of patient-initiated messages (per patient) significantly decreased (mean 2.3 vs 1.4; P =.02). Patients who received the new dismissal information were significantly less likely to have an emergency department visit (20% vs 4%;P = .02). There were no differences in 30-day unplanned office visits (P =.75) or readmissions (P = 1.0).
Reducing grade level readability of hospital dismissal information was associated with significantly lower rates of patient-initiated messages and emergency department visits. This intervention represents a valuable opportunity for improving the quality of patient care and decreasing postoperative care burden on the healthcare system.
评估降低医院出院总结信息的阅读水平对机器人辅助前列腺根治术后患者与医务人员进行非计划性接触的数量的影响。
一个多学科团队将前列腺切除术患者出院时的医院出院总结信息进行修订，将阅读水平从 13 级降低到 7 级。我们进行了一项回顾性队列研究，比较了 30 天的结果测量指标，包括：患者发起的电话和在线消息、非计划性门诊就诊、再入院率和干预前后的急诊就诊。两组患者的围手术期其他做法保持不变。
共有 110 例患者纳入研究（干预前 n=60，干预后 n=50）。患者年龄（P=0.72）、种族（P=0.59）、婚姻状况（P=0.39）和教育水平（P=1.0）在两组之间相似。干预前，有 11.7%的患者报告的教育水平低于 13 级，而干预后有 2%的患者教育水平在 7 级或以下。在修改出院信息后，患者发起的信息数量（每位患者）显著减少（平均 2.3 次比 1.4 次；P=0.02）。接受新出院信息的患者急诊就诊的可能性显著降低（20%比 4%；P=0.02）。30 天内非计划性门诊就诊（P=0.75）或再入院率（P=1.0）无差异。
降低医院出院总结信息的可读性水平与患者发起的信息和急诊就诊率显著降低相关。这种干预为改善患者护理质量和减轻医疗系统术后护理负担提供了有价值的机会。
