Patients leave ER with poor understanding of how to care for themselves

In a new review article, researchers at the University of Toronto, The Hospital for Sick Children (SickKids) and Children's Hospital Boston have found there frequently is a lack of patient-family comprehension at the time of discharge from the emergency department, leaving patients and families unable to report the diagnosis or understand instructions for at-home care, medication use or reasons to return to the hospital. The review article was published in the January issue of Annals of Emergency Medicine . Researchers reviewed more than 50 studies from both adult and pediatric populations in databases that contain journals from around the world. The researchers summarized the current risks associated with insufficient communication at the time of discharge and also provide recommendations to improve patient and family comprehension. "Discharge communication is an opportunity to recap the visit, teach patients and families how to safely care for themselves or their loved ones at home, and address any remaining questions," said Stephen Porter, an associate professor of pediatrics at U of T. "Failure to understand important elements of care can result in medical error at home and safety risks, including incorrect medication use, inappropriate home care and failure to follow-up on concerning symptoms." Researchers recommend that instructions be given verbally, in writing and with visual representation to improve comprehension. Patients need structured content and clear instructions about at-home care with opportunities to ask questions, they say.