Education attainment level of caregivers versus readability level of written instructions in a pediatric emergency department

Chacon, Daniela; Kissoon, Niranjan; Rich, Sharon

doi:10.1097/00006565-199406000-00006

Cited by 31 publications

(18 citation statements)

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“…One modification specific to the discharge process that may prove helpful fin reducing readmissions is the use of discharge materials written at reading levels appropriate for a broad range of patients. Work done in emergency departments has repeatedly found that discharge instructions are often written above patients’ reading levels, using medical language that is difficult to understand (26-29). …”

Section: Discussionmentioning

confidence: 99%

Joint Commission Requirements for Discharge Instructions in Patients With Heart Failure: Is Understanding Important for Preventing Readmissions?

Regalbuto

Maurer

Chapel

et al. 2014

Journal of Cardiac Failure

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Background Many approaches have been considered to reduce heart failure (HF) readmissions. The Joint Commission (JCO) requires hospitals to provide patients admitted for HF with discharge instructions that address six topics related to HF management: diet, exercise, weight monitoring, worsening symptoms, medications, and follow up appointments. These guidelines were developed based on expert opinion, but no one has tested whether patients’ understanding of these instructions affects 30-day readmission rates. Methods and Results We conducted a prospective cohort study of patients admitted for decompensated HF. Patients completed an understanding survey immediately after their nurse read their discharge papers. The survey contained one question for each of the six JCO topics. Of the 145 patients in the study, only 14 (10%) understood all 6 discharge instructions. Patients with complete comprehension of their discharge instructions were significantly less likely to be readmitted within 30 days than those with non-perfect understanding (p = 0.044), but this association was no longer significant after controlling for level of education and use of English as a primary language. Conclusions HF patients’ comprehension of discharge instructions is inadequate. Patients with limited education and those that do not speak English as a primary language are more likely to have poorer discharge understanding and higher rates of 30-day readmissions.

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Section: Discussionmentioning

confidence: 99%

Joint Commission Requirements for Discharge Instructions in Patients With Heart Failure: Is Understanding Important for Preventing Readmissions?

Regalbuto

Maurer

Chapel

et al. 2014

Journal of Cardiac Failure

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show abstract

“…53 In a pediatric ED, it was found that several of the written instruction forms were above many parents' reading levels. 54 Physicians also significantly overestimate their patients' understanding of discharge treatment instructions. 55 It is worth noting that the various validated scales used in the studies of patient literacy may be useful in regular assessment of patient literacy in practice, outside of research studies.…”

Section: Considerations For Instructional Materialsmentioning

confidence: 99%

Patient Education in the Emergency Department

Wei

Camargo

2000

Academic Emergency Medicine

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Abstract. The emergency department (ED) visit provides an opportunity for patient education. Many ED patients have poor access to regular health care, including patient education. Accreditation standards, legal considerations, and cost-efficiency concerns encourage the clinician to implement formal patient education in the ED. More importantly, published clinical studies evaluating patient education in both the ED and comparable settings support the hypothesis that ED-based patient education improves outcomes. The article discusses considerations for instructional material, highlights challenges to ED-based patient education, and suggests possibilities for future research.

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“…In spite of the fact that the number of patients visiting the ED usually outnumbers in-patients, these patients leave the hospital with varied types of DI. It has been suggested that misinterpretation of these instructions adversely affects patient compliance, appropriate use of medications, treatment, follow-up and outcome [1–3, 5–9]. Also, patient recall of verbal instructions can be poor [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Pre-formatted written discharge summary—a step towards quality assurance in the emergency department

Rajavelu

Rajagopalan

2008

Int J Emerg Med

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BackgroundProviding discharge instructions to emergency department (ED) patients is not a standard practice and there is wide disparity in its implementation. There is evidence that ED discharge instructions, especially a pre- formatted one, complements verbal instructions and improves patient communication and management.AimsOur aim was to audit the practice of providing a discharge summary in a standardized pre-formatted form to patients visiting the ED at Sundaram Medical Foundation (SMF), Chennai, India.MethodsCase sheets of 200 patients who visited the ED from 1 July to 31 August 2007 were selected randomly and were assessed for the documentation of the demographic and clinical details in the retained copy of the discharge summary by three medical records personnel independently. Descriptive analysis was used to measure frequency and percentages.ResultsAll patients (100%) received a discharge summary and a carbon copy of the same was retained in the hospital. Demographic data, diagnosis, prescription and discharge instructions were written in > 80%. Legibility of the three important sections, namely diagnosis, prescription and discharge instructions, were 66, 76 and 65%, respectively. The diagnosis was written in an abbreviated form in 27%. The patient’s signature was obtained in 80%, while doctors signed in 89%. Investigation results and follow-up advice were not documented in 85 and 93%, respectively. ConclusionThe pre-formatted discharge summary provided more information than a prescription form in terms of the amount of information written by virtue of its structured nature. Deficiencies did reflect a resistance to change current practices in spite of having a structured data sheet. Physician and staff education could overcome this.

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Education attainment level of caregivers versus readability level of written instructions in a pediatric emergency department

Cited by 31 publications

References 0 publications

Joint Commission Requirements for Discharge Instructions in Patients With Heart Failure: Is Understanding Important for Preventing Readmissions?

Joint Commission Requirements for Discharge Instructions in Patients With Heart Failure: Is Understanding Important for Preventing Readmissions?

Patient Education in the Emergency Department

Pre-formatted written discharge summary—a step towards quality assurance in the emergency department

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