The Importance of Recording Discharge Instructions to Improve Patient Outcomes and Reduce Hospital Readmissions

Hospital discharge has been characterized as patient safety’s “perfect storm.” Care transitions, particularly from the hospital to home or post-acute care, represent a vulnerable period for acutely ill patients and their family caregivers too often characterized by gaps in care and avoidable problems such as worsening symptoms, adverse effects from medications, unaddressed test results, failed follow-up testing, rehospitalizations, and emergency department visits. The goal of discharge planning is to ensure that patients have the information, support, and resources they need to continue their recovery after discharge. One of the most important elements of a successful discharge plan is clear and comprehensive discharge instructions. A study funded by the Agency for Healthcare Research and Quality found that patients who have clear understanding of their after-hospital care instructions are 30% less likely to be readmitted to the inpatient setting or visit the ED than patients who lack this information. Additionally, studies have shown that recording discharge instructions can significantly improve patient outcomes and reduce readmissions. Reasons for why and how are as follows:

Why Recording Discharge Instructions is Essential to Patient Outcomes

1. Improves Communication

Clear and concise discharge instructions can help to improve communication between patients and healthcare providers. Patients are often overwhelmed and stressed when leaving the hospital, and may forget important details of their discharge plan. Recording discharge instructions ensures that patients, their families and other follow-up care givers have a permanent record of the information they need to follow through with the prescribed  recovery plan

2. Reduces Confusion

Patients who receive detailed discharge instructions are less likely to experience confusion about their care plan, which can lead to poor outcomes and readmissions. When patients have a clear understanding of what they need to do to manage their health, they are more likely to adhere to their treatment plan and avoid unnecessary readmissions.

3. Increases Patient Satisfaction

Patients who receive clear and comprehensive discharge instructions are more satisfied with their care and experience a higher level of confidence in managing their health after leaving the hospital. This improved satisfaction can also lead to improved patient engagement, which can help to reduce readmissions and improve health outcomes.

4. Enhances Clinical Outcomes

Recording discharge instructions can also have a positive impact on clinical outcomes. When patients have a clear understanding of their care plan, they are more likely to follow through with their treatments and take their medications as prescribed. This can lead to improved health outcomes and reduced readmissions.

4. Reduces Clinical Burnout

According to the book Compassionomics,”... Decades of rigorous research have identified three hallmarks of burnout: emotional exhaustion (being emotionally depleted or overextended), a lack of personal accomplishment (the feeling that one can’t really make a difference), and depersonalization. Depersonalization is the inability to make that personal connection.” Essentially it's a virtuous cycle. If a physician can effectively use empathy to impact their patient’s outcomes, they will be less likely to burnout and more likely to be empathetic .  Imagine that!  Do what you love and the rest will work itself out.  However if the patient isn’t listening then we tend to stop caring. Recording the empathy conveyed during a conversation with a patient not only helps the patient but it also helps the clinician.  

How to Record Discharge Instructions

There are a number of ways to record discharge instructions, including:

1. Written Instructions

Written instructions are a traditional method of recording discharge instructions. They can be provided to patients in the form of a handout, brochure, or informational packet. The advantage of written instructions is that they can be reviewed and referenced by patients as needed. The major disadvantage is that they have become overloaded with compliance related items that patients don’t often read and don’t care about. Most patients discard the written instructions because they are often hard to understand or are overwhelming. 

2. Audio, Video, and Screen Recordings

Audio, video, and screen recordings can be used to provide patients with more engaging and interactive discharge instructions. This can be especially helpful for patients who have difficulty reading or retaining information,  are medicated, or not mentally alert at the time of discharge. Audio and video recordings can also be accessed and reviewed by patients, family members and extended care teams as needed. In this way, patients and care givers always have something to refer back to,  This is the core to what Playback Health offers. This novel approach to communications represents the future of healthcare communications. 

3. Electronic Health Records

Electronic health records (EHRs) can be used to store and share discharge instructions with patients. EHRs allow healthcare providers to easily access and update discharge instructions as needed, and patients can access their discharge instructions online. We have seen however, that EHRs have some significant challenges such as being hard to use for patients, notoriously behind the technology curve, don’t often include multimedia, and lack a universal patient login across health systems. Utilization rates across the industry by patients remains very low. 

In conclusion, recording discharge instructions is an essential step in the discharge planning process. It can improve communication, reduce confusion, increase patient satisfaction, and enhance clinical outcomes. By utilizing a combination of written instructions, audio and video recordings, and electronic health records, healthcare providers can help to ensure that patients have the information and support they need to continue their recovery at home. Here at Playback Health we are passionate about patient outcomes and trying to leverage technology to positively impact the patient / provider bond.