From the Guidelines
In the emergency department, discharge instructions should prioritize patient safety and recovery by including clear, written information about diagnosis, medications, potential side effects, and follow-up care, as well as ensuring clinical stability for 24-48 hours before discharge and access to social, mental health, and substance use disorder services, as recommended by the most recent guidelines 1. When creating discharge instructions, it is essential to consider the patient's individual needs and provide personalized information. This includes:
- Screening for mental health, substance use disorders, and social care needs before discharge
- Ensuring clinical stability for 24-48 hours before discharge
- Ensuring access to social, mental health, and substance use disorder services
- Conducting medication reconciliation and patient counseling by an inpatient pharmacist before discharge
- Scheduling an initial outpatient follow-up appointment within 48 hours of discharge and a follow-up with a pulmonologist within 2-4 weeks, as outlined in the guidelines 1. The importance of effective discharge communication in the emergency department cannot be overstated, as it directly impacts patient outcomes and their ability to manage their condition at home 1. By prioritizing patient safety and recovery, and following the most recent guidelines, healthcare providers can reduce the risk of readmissions, improve medication adherence, and enhance overall patient care.
From the Research
Discharge Instructions in the Emergency Department
- The purpose of discharge instructions is to provide patients with clear information about their post-emergency department management, including diagnosis, treatment, and follow-up care 2.
- Effective communication between the physician and patient is required for optimum post-emergency department management, and written discharge instructions can improve communication and patient management 2.
- Studies have shown that patients often receive incomplete discharge instructions that are written at a high reading level, leading to poor understanding 3, 4.
Improving Patient Understanding of Discharge Instructions
- Standardized discharge instructions containing key components, such as diagnosis, new medications, at-home care, duration of illness, reasons to return, and follow-up, can improve patient understanding 3.
- Simplifying discharge instructions, such as using a one-page information page, can also improve patient understanding and treatment compliance 4.
- Patient-centered outcomes, such as health literacy and patient satisfaction, can be improved by assessing the effectiveness of discharge instructions and identifying areas for improvement 4.
Best Practices for Discharge Instructions
- Emergency departments should establish uniform policies to promote best practice in communication and provide structured, pre-formatted instruction sheets to all patients discharged to home 2.
- Discharge instructions should be written at a readable level, ideally at a sixth-grade reading level or lower, to improve patient understanding 3, 4.
- Healthcare providers should assess the effectiveness of their teaching and identify areas for improvement to ensure that patients have complete understanding of their discharge instructions 4.