Hospital discharge represents a potentially dangerous transition in care requiring active engagement with patients and their caregivers. Ensuring that patients undersland any new diagnoses, medications and dosing changes, and follow‐up is essential to preventing adverse events. Misunderstandings at discharge have the potential to cause serious harm and may explain recent research reporting that 1 in 5 discharged Medicare patients are rehospilalized within 30 days. Given these findings, we evaluated general medicine patients' knowledge about their hospitalization at discharge.
Patient's knowledge at hospital discharge was measured using the Discharge Knowledge Assessment Tool (DKAT), which assesses the following key areas of a patient's hospitalization: discharge diagnoses, tests undertaken, primary treatments, changes in medications, recommended lifestyle changes, and follow‐up care. Patients were recruited by having their hospitalist page the research coordinator at the time of discharge. Patients who were confused or did not speak English were excluded. After both the patient's nurse and physician provided discharge instructions, a research coordinator surveyed consenting patients about their hospitalization and discharge instructions utilizing the DKAT. Two hospitalists independently reviewed these DKATs along with the patient's official discharge instructions and discharge summary. Patient responses were scored as fully, partially, or not correct. Physician reviewers had an agreement rate of 90%, and any disagreements were resolved by consensus with a third reviewer.
For the 130 patients initially enrolled, the average age was 54, 60% were female. 40% white, and 50% African American. Education level varied from college degree or higher (39%), some college (32%), high school graduate or GED (18%), to never graduating high school (11%). About 1 in 7 patients either completely misunderstood (6.7%) or partially misunderstood (8%) their hospital diagnosis. Almost all patients (95.7%) comprehended results from important tests performed during their hospitalizatian (e.g., MRIorCT). Most (83%) completely understood their follow‐up appointments plans, but 1 in 8 patients (13%) did not understand their scheduled follow‐up tests. One in 5 (22%) did not fully understand the lifestyle changes recommended. Finally, about 1 in 4 (26%) did not fully understand the purpose of their medications or how to use them properly.
Overall given the high level of education within our study population, a surprising number of patients lacked understanding about their hospitalization, medications, and what they need to do on discharge. Further research should explore interventions that increase patients' knowledge of important issues related to their hospilalization and how it may reduce the rate of subsequent adverse events and readmissions to the hospital.
V. Forth, none; A. Creden, none; A. Leung, none; E. Meyers, none; D. Magill, none; C. Lawes, none; M. Williams, none.
To cite this abstract:Leung A, Forth V, Creden A, Meyers E, Magill D, Lawes C, Williams M. Patient's Knowledge about Their Hospitalization at Discharge. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 86. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/patients-knowledge-about-their-hospitalization-at-discharge/. Accessed May 23, 2019.