Hospitalized patients receive a large amount of medical information from their healthcare team. Patient understanding of medical care reduces readmission rates and improves patient satisfaction, yet the literature suggests that patients often have poor retention of the large amount of care information they received despite numerous interventions.
A new study in the February 2023 issue of The Joint Commission Journal on Quality and Patient Safety (JQPS) evaluated how well patients retain care information after hospital discharge and assessed patient perspectives on facilitators of this process, such as whiteboards, discussions with providers, discharge paperwork and patient portal.
Researchers at the University of Michigan School of Medicine, Ann Arbor, Michigan, conducted semi-structured phone interviews of patients admitted to general medicine resident teaching services within 24 to 48 hours post-hospitalization to assess their recall of four key domains of care:
· Diagnoses addressed
· Inpatient treatment
· Post-discharge treatment plans
· Medication changes
Chart review verified patient responses which were then categorized by independent reviewers as correct, partially correct or incorrect.
Results showed the vast majority (90%) of patients were confident in their knowledge of their diagnoses and treatment, yet independent review revealed only:
· 58.5% correctly recalled diagnoses addressed
· 64.2% correctly recalled inpatient treatment
· 50.9% correctly recalled post-discharge treatment plans
· 43.4% correctly recalled medication changes
Whiteboards were the most frequently used facilitator (96.2%), yet their content was rated least helpful for retaining care information. Patients suggested several areas for improvement, including prioritizing bedside pen and paper along with updating whiteboards with diagnostic and therapeutic information.
“Patient education and engagement is considered a key component of transitional care efforts, leading to the development of standardized discharge instructions and patient-centered discharge tools,” notes Blair P. Golden, MD, MS, and Karen Okrainec, MD, MSc, FRCPC, in an accompanying editorial. “Health systems must proactively address disparities that exist with regard to patient and caregiver engagement surrounding care transitions, in addition to broader structural determinants of health that have been shown to contribute to health outcomes.”