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Knowledge Deficits at ED Discharge

Knowledge Deficits at ED Discharge

Effective communication between caregivers and patients is a critical element of providing high-quality patient care in the ED. In recent years, a greater emphasis has been placed on information delivery at ED discharge and its downstream implications for adherence and outcomes. “Despite recognizing the importance of communication, the complex ED environment can make it challenging to communicate effectively,” says Kirsten G. Engel, MD. “Many patients leave the ED with an incomplete understanding of their care and instructions.” (see also, Communicating More Effectively at ED Discharge) The causes of poor communication at ED discharge are multifactorial and likely reflect problems with both written and verbal communication. Written discharge instructions often exceed patients’ health literacy or reading levels, and verbal communication is frequently brief and incomplete. Previous research has suggested that the majority of patients have a comprehension deficit for at least one area of their ED care and instructions, with the most frequent deficits found in the domain of post-ED care. “The effect of poor discharge communication is profound because many patients are leaving the ED without the knowledge they need to properly care for themselves at home,” Dr. Engel says. “This increases their risk for adverse events, as well as repeat ED visits and hospitalization.” Deficits in Patient Understanding at Discharge To address problems with information delivery at ED discharge, Dr. Engel says it is essential to better define deficits in patients’ understanding of discharge instructions. “We need to characterize knowledge gaps that may put patients at risk for complications or poor outcomes following their ED visits,” she adds. “Identifying these areas serves as a critical next step in...
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