Abstract
IntroductionWhen discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions. However, numerous factors make it difficult to ensure that patients understand their next steps. Our objective was to determine whether patient understanding of ED discharge and aftercare instructions could be improved through instructional videos in addition to standard written discharge instructions.MethodsThis was a prospective pre- and post-intervention study conducted at a single-center, academic tertiary care ED. Patients presenting with the five selective chief complaints (closed head injury, vaginal bleeding, laceration care, splint care, and upper respiratory infection) were given questionnaires after their discharge instructions to test comprehension. Once video discharge instructions were implemented, patients received standard discharge instructions in addition to video discharge instructions and were given the same questionnaire. A total of 120 patients were enrolled in each group.ResultsThere were significantly better survey scores after video discharge instructions (VDI) vs standard discharge instructions (SDI) for the closed head injury (27% SDI vs 46% VDI, P = 0.003); upper respiratory infection (28% SDI vs 64% VDI; P < 0.0001); and vaginal bleeding in early pregnancy groups (20% SDI vs 60% VDI, P < 0.0001). There were no significant differences in survey scores between the splint care (53% SDI vs 66% VDI; P = 0.08) and suture care groups (29% SDI vs 31% VDI; P = 0.40).ConclusionVideo discharge instructions supplementing standard written instructions can help improve patient comprehension and information retention. This better understanding of aftercare instructions is essential to patient follow-up and has been shown to improve patient outcomes.
Highlights
When discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions
There were no significant differences in survey scores between the splint care (53% standard discharge instructions (SDI) vs 66% video discharge instructions (VDI); P = 0.08) and suture care groups (29% SDI vs 31% VDI; P = 0.40)
There were significantly better survey scores after VDIs vs SDIs for the closed head injury (27% SDI vs 46% VDI, P = 0.003); upper respiratory infection
Summary
Discharge of patients from the emergency department (ED) generally includes physician discussion with the patient regarding results, treatment, and discharge plan, followed by the patient receiving paper discharge instructions, which are reviewed with the patient by the nurse at the time of discharge. This process is standard in many EDs across the United States, it is severely flawed. Many factors including time constraints and the unpredictability of the ED contribute to this flaw.[1] Due to time constraints on both physicians and Educational Videos Improve Communication and Discharge Instructions nurses, the amount of time to answer questions and ensure patient understanding during discharge is limited. This issue is complicated by the fact that approximately 14.5% of individuals aged 16 years or older are illiterate (National Assessment of Adult Literacy).[7]
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