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    Science Saturday: Simpler instructions lead to better outcomes for patients

Critical care patient in ICU on Florida campusA Mayo Clinic study found that when patients leave the hospital with instructions that are easy to read, they have better health outcomes.

When you leave the hospital following an injury, stroke, surgery or other event, you are loaded down with instructions on how to take care of your body, prepare your home and your family, and what medications to take when and how. And more than likely, the instructions include complicated medical jargon.

A Mayo Clinic research study examined the implications of these instructions on the health outcomes for patients following hospital visits. Researchers also looked at the effect on patient care outcomes when the patients received more readable instructions.

The findings were published in PubMed.

Studying the implications of readability

Asad Choudhry, M.B.B.S., was a trauma research fellow at Mayo Clinic when he started thinking about the complicated set of instructions patients receive when they go home after a hospital visit.

While collecting data for another research study, Dr. Choudhry noticed that many patients tended to call their providers back for the same few reasons — mostly to clarify written instructions they had received in their discharge summaries.

Dr. Choudhry and Martin Zielinski, M.D., a Mayo Clinic surgeon, assembled a research team to examine this pattern. Their initial study looked at the readability of discharge instructions to figure out the grade level of the instructions the Mayo Clinic Trauma Center was using. They were quick to note that it was at the 10th grade level — much higher than the sixth grade level recommended by the National Institutes of Health and American Medical Association.

In reviewing the electronic health records of nearly 500 patients, they found 27 percent received instructions that were difficult to read. They also found that 40 patients were readmitted within 30 days, and of those, 65 percent had reading skills below the level that was used to write their original discharge instructions.

"At the time, there were some guidelines on the appropriate reading level of discharge information," Dr. Choudhry says. "However, there was little information about the effect of improved readability on patient return phone calls as well as readmissions."

So the research became a two-part effort. First, the researchers set out to understand the level of information patients received on discharge, compared to national guidelines. Second, they analyzed the effect on patient care outcomes when the patients received more readable instructions.

"It was an area lacking in quality data," Dr. Zielinski says. "And there were outstanding opportunities to improve patient care and understanding."  Read the rest of the article on Advancing the Science blog.


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