Recall and understanding of discharge information in observation ward patients.

Abstract

Discharge instructions are an important part of patient care and the understanding of these instructions may be critical to avoid readmissions and complications. Previous studies have shown great variations in patient recall and understanding of medical instructions. The purpose of this study is to assess the recall of discharge information when information is provided both verbally and written, with especially focus on information conveyed in the discharge encounter, the patient’s recall of instructions and the patient’s and the physician’s perception of main message. This cross-sectional, interview-based study includes data of 13 patients discharged from an observation ward. The discharge encounters were videotaped and immediately after the encounter, the patients and physicians were separately asked a selection of questions. Two weeks after discharge the patients took part in a semi-structured interview via telephone. All the patients received written information, but only half of the physicians reviewed the paper with the patient during the discharge encounter. The information most patients had deficient recall of was about medication. However, patients reported that they were satisfied with the information and the communication. Patients and physicians emphasized different instructions as the main message in half of the encounters. Greater provider awareness of the patient’s participation in the encounter and including the patient’s perspective may lead to more effective communication. Increased focus on simple communication strategies may be useful.