When patients are discharged from the hospital, their recovery depends on carefully following the doctors' instructions for their post care at home. Yet a vast majority of patients don't fully understand what they are supposed to do, and most are not even aware of how much their understanding falls short.
Recently, clinicians at Northwestern University's Feinberg School of Medicine found that more than three-quarters of patients (78 percent) do not fully understand the care and discharge instructions they receive from the emergency department. In addition, 80 percent of the time, patients weren't aware they didn't get it.
"It's distressing," said Kirsten Engel, M.D., a clinical instructor and lead author of the paper, which was published online in the Annals of Emergency Medicine. "Patients who fail to follow discharge instructions may have a greater likelihood of complications after leaving the emergency department."
Hospital patients must understand their diagnosis, their care, and their discharge instructions, the paper says. It is disturbing that so many patients do not understand their post-Hospital care. This occurred recently for my wife, leaving the hospital after a colonoscopy. Hurried instructions were given her by a nurse as she was ushered out the door, but when we were at home later, we had no idea what those instructions had included.
In this case, researchers assessed 138 patients and 2 caretakers in four categories of comprehension: diagnosis and cause, emergency department care, post-emergency department care and return instructions. About half (51 percent) did not understand fully what they were told in two or more categories. More than one-third (34 percent) of the comprehension deficiencies involved patients' understanding of post-emergency department care, while 15 percent involved diagnosis and cause. Of those patients with comprehension difficulties, only 20 percent realized that their understanding was incomplete or inaccurate.
While this study was done on emergency care, as my wife and I have discovered, the same problem concerns hospital staff in other areas. After care is important . . . doctors and nurses need to be trained to provide this, and patients need to remember how important it is to get it right.