Read-backs might help — Do you have the time?
In light of a recent study in the Annals of Emergency Medicine,1 some experts recommend that EDs use "read-backs" by asking the patient to repeat back what they have been told to verify whether patients have understood their instructions. However, support is not universal among ED managers.
"That wouldn't work in my ED. We're too busy," says Bruce Janiak, MD, FACEP, FAAP, professor of emergency medicine, Medical College of Georgia and vice chair of the ED the Medical College of Georgia Hospital, both in Augusta.
Society keeps taking responsibility away from the individual, Janiak says. "The consumer has responsibility as well," he says. "Personally, I'd be willing to make the effort, but not to do anything extraordinary." Exceptions can be made for individual patients, he adds, "but that's the doctor's decision."
However, doing read-backs might not add to total staff time, counters Kirsten Engel, MD, a clinical instructor in the Department of Emergency Medicine at Northwestern University's Feinberg School of Medicine, an ED physician at Northwestern Memorial Hospital in Chicago, and lead author of the recent study. "It actually ends up saving time because we are focusing on the areas the patient does not understand well," Engel says. "If we did not focus that way and the patient left and came back, then we'd have to spend additional time with that same patient."
Reference
- Engel KG, Heisler M, Smith DM, et al. Patient comprehension of emergency department care and instructions: Are patients aware of when they do not understand? Ann Emerg Med 2008; Doi:10.1016/j.annemergmed.2008.05.016.
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