Original Article

Standardized Physician-Administered Patient-Centered Discharge Protocol Improves Patients’ Comprehension

Authors: Jennifer W. Caceres, MD, Scott M. Alter, MD, Richard D. Shih, MD, Jimmy D. Fernandez, MD, Frederick K. Williams, MD, Richard Paley, MD, William Benda, MD, Lisa M. Clayton, DO

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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