Best practice strategies can improve DP
Expert refers to personal experience
There are multiple small ways and steps hospitals can take to improve their patients' discharge instructions and care.
The teach-back method is one practical and simple way to confirm a patient's understanding of discharge instructions, says Terry Davis, PhD, professor of medicine and pediatrics at the Louisiana State University Health Sciences Center at Shreveport, LA.
Davis suggests these other strategies for improving the discharge process:
Make patient discharge papers more user-friendly. Hospitals can improve their patient education materials for discharge by making them simpler. They can do this by giving people exactly the medical information they need, such as which drugs they'll be taking and why, and how they'll [take] these, Davis says.
"People need health information that is accurate, accessible, and actionable," she adds.
Davis has seen some excellent examples of this, including one discharge sheet that showed illustrations of breakfast, lunch, dinner, and bedtime accompanied by a list of medications that would be taken at any of these times in the day.
"These instructions had everything a patient would need to know, and it did this in Chinese, Spanish, and English," Davis says.
Design a discharge program from the patient's perspective. "Ask patients what they need to know," she says. "After patients tell you what they need to do, put it down on paper with plain language and pictures and test it out to see if it was helpful."
Hospitals should initiate a program with oral and written communication components.
The written component should have space between sentences and illustrations when applicable.
"It needs to be broken down and be shown with charts," Davis says.
The oral component should be interactive, with the discharge nurse asking patients questions about which drugs they're taking and which times of the days they'll be taking them, she says.
The discharge nurse also could help patients figure out how to incorporate their new medication regimen into their daily lifestyle by asking them how they store their medications and when they are most likely to remember to take them, Davis says.
For instance, discharge nurses could teach patients to take their medicine at breakfast and dinner, their cues to establishing this habit.
Have someone available to answer questions post-discharge. Some hospitals call this a "warm line," meaning it's not the number patients call for actual emergencies, but a number to call when they have minor symptoms or do not understand their discharge instructions.
This doesn't have to be a line that is continuously manned, but there should be concerted effort to have these patient calls returned within 24 hours.
"I like the idea of a warm line, because the teachable moment is when you have the problem," Davis says.
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