Researchers say patients leave ER with poor understanding of how to care for themselves

January 25, 2012, University of Toronto

(Medical Xpress) -- In a new review article, researchers at the University of Toronto, The Hospital for Sick Children (SickKids) and Children’s Hospital Boston have found there frequently is a lack of patient-family comprehension at the time of discharge from the emergency department, leaving patients and families unable to report the diagnosis or understand instructions for at-home care, medication use or reasons to return to the hospital.

The review article was published in the January issue of . Researchers reviewed more than 50 studies from both adult and pediatric populations in databases that contain journals from around the world. The researchers summarized the current risks associated with insufficient communication at the time of discharge and also provide recommendations to improve patient and family comprehension.
 
“Discharge communication is an opportunity to recap the visit, teach and families how to safely care for themselves or their loved ones at home, and address any remaining questions,” said  Dr. Stephen Porter, an associate professor of pediatrics at U of T. “Failure to understand important elements of care can result in medical error at home and safety risks, including incorrect medication use, inappropriate home care and failure to follow-up on concerning symptoms.”
 
Researchers recommend that instructions be given verbally, in writing and with visual representation to improve comprehension. Patients need structured content and clear instructions about at-home care with opportunities to ask questions, they say.

Porter explained that patients and families with limited understanding of health terms or language fluency are likely to be at a higher risk of leaving the emergency room  with insufficient comprehension.

“Poor understanding of instructions may also increase the risk of the patient revisiting the ,” said Porter, who is also principal investigator of the review and head of emergency medicine and senior associate scientist in child health evaluative sciences at SickKids.“It’s a two-way conversation that has often been overlooked.

“Language, appropriate reading level and use of medical terms need to be considered so that the conversation can be tailored to the patient.”
 
The researchers focused on studies that examined the content, delivery and comprehension of discharge instructions. They found in one study that although 76 per cent of the patients received an explanation of their symptoms, only 34 per cent received instructions about symptoms that should cause them to return to the hospital. They also found that even when instructions were detailed and complete, deficient comprehension can result if instructions are not presented in a way that is understandable to the patient or relative.
 
Another study included in the review found that while 72 per cent of patients could read the discharge instructions aloud, only 49 per cent could report the treatment plan back to the health-care provider.
 
“While improved communication at discharge from the emergency room is crucial for patient safety, future research should address the relationship between discharge process and outcomes, including preventable morbidity and mortality, and cost to the health-care system,” said Porter.

Explore further: Discharge summaries play key role in keeping nursing home patients safe

Related Stories

Discharge summaries play key role in keeping nursing home patients safe

December 22, 2011
(Medical Xpress) -- Sending thorough and timely reports to nursing homes when a patient is discharged from the hospital could help promote patient safety during the early days after a hospitalization.   Yet, these reports ...

Temporary memory loss strikes hospitalized seniors

April 14, 2011
Battling an illness, lack of sleep and strange surroundings can make any hospital patient feel out of sorts.

Telemedicine 'robot' allows stroke specialists to remotely evaluate patients in oak park

May 9, 2011
Acute stroke patients who arrive at Rush Oak Park Hospital’s emergency room can now be seen immediately by a Rush University Medical Center stroke neurologist without the specialist actually being there. 

RN staffing affects patient success after discharge

April 26, 2011
Higher non-overtime staffing levels of registered nurses lower the probability of patient readmissions to the hospital, a new study finds. However, higher levels of RN overtime increase the likelihood of unplanned visits ...

Recommended for you

Marijuana use does not lower chances of getting pregnant

January 22, 2018
Marijuana use—by either men or women—does not appear to lower a couple's chances of getting pregnant, according to a new study led by Boston University School of Public Health (BUSPH) researchers.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.