Comparison of computer-generated and traditional emergency department patient discharge instructions: Medication and follow-up compliance and patient perception of care rendered

1994 ◽  
Vol 23 (3) ◽  
pp. 625
Author(s):  
C.W. Felton ◽  
L.J. White ◽  
J. Dougherty
Keyword(s):  
Emergency Department ◽  
Patient Discharge ◽  
Emergency Department Patient ◽  
Patient Perception ◽  
Discharge Instructions ◽  
Perception Of Care

scholarly journals Information Technology Improves Emergency Department Patient Discharge Instructions Completeness and Performance on a National Quality Measure

2013 ◽  
Vol 04 (04) ◽  
pp. 499-514 ◽  
Author(s):  
E.J. Bell ◽  
S.S. Takhar ◽  
J.R. Beloff ◽  
J.D. Schuur ◽  
A.B. Landman
Keyword(s):  
Emergency Department ◽  
Information Technology ◽  
Experimental Study ◽  
Patient Discharge ◽  
Emergency Department Patient ◽  
Quality Measure ◽  
Discharge Instructions ◽  
National Quality ◽  
Quasi Experimental ◽  
And Performance

SummaryObjectives: To compare the completeness of Emergency Department (ED) discharge instructions before and after introduction of an electronic discharge instructions module by scoring compliance with the Centers for Medicare and Medicaid Services (CMS) Outpatient Measure 19 (OP-19).Methods: We performed a quasi-experimental study examining the impact of an electronic discharge instructions module in an academic ED. Three hundred patients discharged home from the ED were randomly selected from two time intervals: 150 patients three months before and 150 patients three to five months after implementation of the new electronic module. The discharge instructions for each patient were reviewed, and compliance for each individual OP-19 element as well as overall OP-19 compliance was scored per CMS specifications. Compliance rates as well as risk ratios (RR) and risk differences (RD) with 95% confidence intervals (CI) comparing the overall OP-19 scores and individual OP-19 element scores of the electronic and paper-based discharge instructions were calculated.Results: The electronic discharge instructions had 97.3% (146/150) overall OP-19 compliance, while the paper-based discharge instructions had overall compliance of 46.7% (70/150). Electronic discharge instructions were twice as likely to achieve overall OP-19 compliance compared to the paper-based format (RR: 2.09, 95% CI: 1.75 – 2.48). The largest improvement was in documentation of major procedures and tests performed: only 60% of the paper-based discharge instructions satisfied this criterion, compared to 100% of the electronic discharge instructions (RD: 40.0%, 95% CI: 32.2% – 47.8%). There was a modest difference in medication documentation with 92.7% for paper-based and 100% for electronic formats (RD: 7.3%, 95% CI: 3.2% – 11.5%). There were no statistically significant differences in documentation of patient care instructions and diagnosis between paper-based and electronic formats.Conclusions: With careful design, information technology can improve the completeness of ED patient discharge instructions and performance on the OP-19 quality measure.Citation: Bell EJ, Takhar SS, Beloff JR, Schuur JD, Landman AB. Information technology improves emergency department patient discharge instructions completeness and performance on a national quality measure: A quasi-experimental study. Appl Clin Inf 2013; 4: 499–514 http://dx.doi.org/10.4338/ACI-07-RA-0046

scholarly journals P092: Exercise prescription in the emergency department: patient perceptions

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S109
Author(s):  
F. Milne ◽  
K. Leech-Porter ◽  
D. Lewis ◽  
J. Fraser ◽  
S. Hull ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Exercise Prescription ◽  
Tertiary Care ◽  
Intervention Group ◽  
Emergency Department Patient ◽  
Likert Scale ◽  
Structured Interview ◽  
Positive Health

Introduction: The positive health outcomes of exercise have been well-studied, and exercise prescription has been shown to reduce morbidity in several chronic health conditions. However, patient attitudes around the prescription of exercise in the emergency department (ED) have not been explored. The aim of our pilot study is to explore patients’ willingness and perceptions of exercise being discussed and prescribed in the ED. Methods: This study is a survey of patients who had been previously selected for exercise prescription in a pilot study conducted at a tertiary care ED. This intervention group were given a standardized provincial written prescription to perform moderate exercise for 150 minutes per week. Participants answered a discharge questionnaire and were followed up by a telephone interview 2 months later. A structured interview of opinions around exercise prescription was conducted. Questions included a combination of non-closed style interview questions and Likert scale. Patients rated prescription detail, helpfulness and likelihood on a Likert scale from 1-5 (1 being strongly disagree and 5 being strongly agree). Median values (+/-IQRs) are presented, along with dominant themes. Results: 17 people consented to exercise prescription and follow up surveys. 2 were excluded due to hospital admission. 15 participants were enrolled and completed the discharge survey. Two-month follow up survey response rate was 80%. Patients rated the detail given in their prescription as 5 (+/-1). Helpfulness of prescription was rated as 4 (+/-2). Likelihood to continue exercising based on the prescription was rated as 4 (+/-2). 11/12 participants felt that exercise should be discussed in the Emergency Department either routinely or on a case-by-case basis.1 participant felt it should not be discussed at all. Conclusion: Our study demonstrates that most patients are open to exercise being discussed during their Emergency Department visit, and that the prescription format was well-received by study participants.

161 Emergency Department Patient Perception of Stroke

2012 ◽  
Vol 60 (4) ◽  
pp. S58
Author(s):  
D. Benaron ◽  
E. Castillo ◽  
G. Vilke ◽  
K. Guluma
Keyword(s):  
Emergency Department ◽  
Emergency Department Patient ◽  
Patient Perception

scholarly journals P061: Barriers to distributing discharge materials in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S86-S86
Author(s):  
A. Maneshi ◽  
H. Gangatharan ◽  
M. Cormier ◽  
S. Gosselin
Keyword(s):  
Emergency Department ◽  
Online Survey ◽  
Annual Conference ◽  
Discharge Instructions ◽  
Patient Comprehension ◽  
Emergency Department Patients ◽  
Time Required ◽  
To Receive ◽  
Common Barriers

Introduction: An efficient discharging process provides an opportunity for the patient to receive information about their diagnosis, prognosis, treatments, follow-up plan and reasons to return. Even when given complete discharge instructions, studies demonstrate that patients have poor retention of the information due to misunderstandings, language barriers, or poor health literacy. This study sought to identify barriers encountered by healthcare workers in providing discharge handouts to emergency department patients. Methods: A bilingual online survey of fifteen questions was shared with Quebec ED staff physicians and residents at the annual conference, and by email correspondence through the Quebec Emergency Medicine Association (AMUQ - L'Association des médecins d'urgence du Québec). Results: There was a total of 126 responses (96 physicians and 30 residents), with a response rate of 22.7% (126/556) and a completion rate of 84.1%. 85.8% (n = 120) responded that they were aware of discharge instructions available in their ED. Most common discharge handouts were concussion/traumatic brain injury and laceration repair. 58.3% of respondents (n = 120) reported having handed out discharge instructions in the last week, 22.5% in the last month, 10.8% within the last 6 months and 5.8% had not given out discharge instructions in the last 6 months. Respondents indicated that the most common barriers to giving out discharge instructions were their difficulty to access and and the time required. 58% of respondents (n = 65) reported handing out discharge handouts less than 50% of the time for conditions that had a discharge handout available at their hospital. Participants reported they would be more likely to give out discharge instructions if they were easier to print and if there was an automatic prompt from the EMR associated with the diagnosis. When asked to rank based on importance (1 = not important to 10 = very important), the majority of respondents thought discharge instructions were very important for patient comprehension, return to ED instructions and managing expectations of the illness (Median 8, Likert scale 1-10, DI 0.29, n = 119). Conclusion: Despite physicians and residents working in the ED believing discharge instructions are important for patient care, handouts are seldom given to patients. The lack of easy availability such as documents automatically available with the prompt of an electronic medical record would likely increase their distribution.

scholarly journals Assessing Documentation of Critical Imaging Result Follow-up Recommendations in Emergency Department Discharge Instructions

2017 ◽  
Vol 31 (4) ◽  
pp. 562-567 ◽  
Author(s):  
Anurag Gupta ◽  
Ronilda Lacson ◽  
Patricia C. Balthazar ◽  
Shan Haq ◽  
Adam B. Landman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Discharge Instructions ◽  
Imaging Result ◽  
Emergency Department Discharge

scholarly journals Teach-back of discharge instructions in the emergency department: a pre–post pilot evaluation

2021 ◽  
pp. emermed-2020-210168
Author(s):  
Gijs Hesselink ◽  
Özcan Sir ◽  
Nadia Koster ◽  
Carolien Tolsma ◽  
Maartje Munsterman ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Transitional Care ◽  
Knowledge Retention ◽  
Self Management ◽  
Academic Hospital ◽  
Discharge Instructions ◽  
Discharge Care ◽  
Full Knowledge

ObjectivesWith the 'teach-back' method, patients or carers repeat back what they understand, so that professionals can confirm comprehension and correct misunderstandings. The effectiveness of teach-back has been underexamined, particularly for older patients discharged from the emergency department (ED). We aimed to determine whether teach-back would reduce ED revisits and whether it would increase patients’ retention of discharge instructions, improve self-management at home and increase satisfaction with the provision of instructions.MethodsA nonrandomised pre–post pilot evaluation in the ED of one Dutch academic hospital including patients discharged from the ED receiving standard discharge care (pre) and teach-back (post). Primary outcomes were ED-revisits within 7 days and within 8–30 days postdischarge. Secondary outcomes for a subsample of older adults were retention of instructions, self-management 72 hours after discharge and satisfaction with the provision of discharge instructions.ResultsA total of 648 patients were included, 154 were older adults. ED revisits within 7 days and within 8–30 days were lower in the teach-back group compared with those receiving standard discharge care: adjusted odds ratios (AORs) of 0.23 (95% CI 0.05 to 1.07) and 0.42 (95% CI 0.14 to 1.33), respectively. Participants in the teach-back group had an increased likelihood of full knowledge retention on information related to their ED diagnosis and treatment (AOR 2.19; 95% CI 1.01 to 4.75; p=0.048), medication (AOR 14.89; 95% CI 4.12 to 53.85; p>0.001) and follow-up appointments (AOR 3.86; 95% CI 1.33 to 10.19; p=0.012). Use of teach-back was not significantly associated with improved self-management and higher satisfaction with discharge instructions. Discharge conversations were generally shorter for participants receiving teach-back.ConclusionsDischarging patients from the ED with a relatively simple and feasible teach-back method can contribute to safer and better transitional care from the ED to home.

scholarly journals Acute Concussion in the Emergency Department

Concussion ◽  
2019 ◽  
pp. 3-8
Author(s):  
Brian Hainline ◽  
Lindsey J. Gurin ◽  
Daniel M. Torres
Keyword(s):  
Emergency Department ◽  
Discharge Instructions ◽  
Early Management ◽  
Concussion Management ◽  
Persistent Symptoms ◽  
Standardized Protocol ◽  
Intracranial Bleed ◽  
Brain Ct Scan ◽  
Structural Lesion

Concussion evaluations are very common in the Emergency Department, but there is no standardized protocol to evaluate and manage concussions. Triage to rule out more severe brain injury is becoming more uniform. For example, there are emerging guidelines and biomarkers for when a brain CT scan should be ordered for a suspected intracranial bleed or other brain structural lesion. However, the nuance of concussion diagnosis and management is less uniform, leaving many patients with a diagnosis and no clear plan for management and recovery—and this fallout can negatively impact recovery. Following concussion diagnosis, discharge instructions are key, as delayed concussion management and lack of follow-up can lead to improper early management, which too often leads to prolonged, persistent symptoms.

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