Discharge instructions for emergency department patients: what should we provide?

Abstract

EVective communication between the physician and patient is required for optimum post-emergency department management. Written emergency department discharge instructions, when used to complement verbal instructions, have been shown to improve communication and patient management. This review examines the purpose, advantages, and disadvantages of three commonly used types of discharge instruction. The desirable features of discharge instructions are described. It is recommended that structured, pre-formatted instruction sheets be provided to all patients discharged to home, that emergency departments establish uniform policies to promote best practice in communication, and that the use of discharge instructions be considered as an emergency department performance indicator. (J Accid Emerg Med 2000;17:86-90)

Listenability as a Tool for Advancing Health Literacy

“…This article explored the use of listenability guidelines in formulating postsurgical instructions. Postsurgical instructions are an interesting case, since much effort has gone into producing better written forms (e.g., Taylor & Cameron, 2000), whereas many patients recall-if they recall the discharge process at all-mostly the verbal interactions with hospital staff (Engel et al, 2009;Flacker et al, 2007). One might well question the disposition of all those print discharge sheets.…”

Return Visits to the Emergency Department: The Patient Perspective

“…The majority of work in regard to improving discharge from the ED has focused on improving the actual discharge process itself, [24][25][26][27][28][29][30][31][32][33][34][35][36] and we find, perhaps as a result, that most patients do not report problems with this process. There is a small body of research exploring patient perspectives about inpatient readmissions.…”

Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

“…While verbal instructions are critical for communicating discharge messages, written information is more likely to be remembered and used than verbal instructions. 2 …”

“…Ideally, for ease of provision and legibility, these instructions should be computerized, standardized, clear, and succinct. 2 In addition to providing standard instructions, many authors promote using the ''teachable moment'' in the ED, when patients and families may be more receptive to specific disease-or injury prevention information. [3][4][5][6][7] While there is evidence that the pediatric ED can be successfully used as a venue to disseminate information about home safety [8][9][10][11] and motor vehicle safety, 12,13 the majority of injured patients do not receive injury prevention information as part of their postcare instructions.…”