A big reason why you make post-visit follow up calls is to remove gaps in care created by non-compliance of discharge instructions.
That's because coaching patients within 24 hours of discharge catches issues quickly.
However, there are things you can (and should) do that will increase the likelihood your patients will understand and retain the instructions they receive at the point of discharge.
One important area to focus on is the take home instructions themselves.
Here are a few ways to make your post-visit discharge instructions easier to understand and recall:
Create a Simple & Clear Format for Discharge Instructions
Are your discharge instructions formatted in a way that makes sense to the patient? Or in other words, do your instructions more closely resemble a complex technical manual or a simple reference guide?
When it comes to providing patients with healthcare instructions, format matters.
The goal is to provide enough information to the patient that will allow them (or their caregiver) to manage their healthcare without giving them so much that it confuses them. How you present that information goes a long way to impacting health literacy.
Here are some general format guidelines:
- Keep sentences brief and to the point.
- Use lists/bullet points as often as possible.
- Don't use small font sizes – a 14 point sans serif is preferable.
- Emphasize important points and calls-to-action using bold, underline, or different colors.
- White space is your friend – don't feel like you need to cram everything into one page.
You may not be able to pre-create all necessary patient care instructions. If your instructions include hand written content, make sure it is legible and follows the same format as the rest of your document.
Write to an Appropriate Reading Grade Level
Creating content that meets a minimum reading grade level – a number that represents a readers ability to understand written content – is extremely important when communicating with a wide variety of patients.
Flesch-Kincaid Formula: Determining reading grade level.
The "Flesch–Kincaid Grade Level Formula" translates the 0–100 score to a U.S. grade level. The grade level is calculated with the following formula:
To ensure crystal clear explanations of patient discharge instructions and medical terminology, we recommend writing your post-visit instructions at a 6th grade reading level.
Use Pictographs or other visual instructions
Even at a 6th grade reading level, patients who have low health literacy or English literacy will struggle to understand and remember their discharge instructions.
Created by a team of clinicians and consumers, the authors of this study utilized pictographs (example to the left) along side their text based instructions.
What they discovered was that the immediate and delayed recall rates for individuals were higher when pictographs were used.
While this was only one pilot study, the message is clear. Don't limit yourself to text.
Color Code Important Information
During your follow up call to the patient, one of the first questions you'll likely ask is whether or not they received their discharge instructions. While this seems like a very clear question, we've received some not so clear answers from recently discharged patients.
When a patient is being discharged from the hospital, they're not feeling great. They're tired, concerned about their condition, and nervous about transitioning home – which really isn't the best state-of-mind to absorb important information.
So when you ask them about their care instructions, they may not remember what you're talking about.
By applying unique colors to your post care instructions, you can help your patients quickly re-associate which pages contain important information about their continued care, and then review accordingly (e.g. Do you have the yellow form that was provided to you when you left the hospital?).
Send a Follow Up Copy of Their Discharge Instructions
It's a little hard to recall your instructions if you don't have any. In the event you discover your patient doesn't have their discharge instructions during the follow up process, there should be a mechanism in place that will send them the information they need ASAP.
Depending on your discharge process, this could be an alert to the patient's discharge planner who will follow up appropriately, or an automated fulfillment process built into your follow up calling software.
What other ways are you clarifying patient discharge instructions?