How well informed are patients when leaving the emergency department? comparing information provided and information retained.

STUDY OBJECTIVE: Patients discharged from the emergency department (ED) should be informed comprehensively and accurately about the diagnosis, future examinations and follow-up care. This study investigates: (1) how comprehensively patients are informed by physicians on discharge; (2) how accurately patients remember this information after discharge; (3) how well informed overall patients leave the ED; and (4) whether informedness relates to patient satisfaction. METHODS: This study compares: (1) information given during discharge conversations, based on audio recordings of the conversations, with (2) accuracy of patient recall of this information, based on postdischarge interviews. During these interviews, the authors also assessed (3) amount and accuracy of information provided during treatment. Furthermore, the authors obtained (4) satisfaction ratings by physicians and patients. Data were collected for 96 patients during 20 shifts. RESULTS: Sufficient information was provided in 83% of discharge conversations. Patients correctly recalled 82% of information received about diagnosis, 56% about examinations planned and 72% about follow-up treatments. Information related to medication was most prone to forgetting or distortion. Altogether, 43% of the patients left the ED correctly informed about diagnosis, planned examinations and follow-up. Patient satisfaction ratings were high (mean 4.7 on a 5-point Likert Scale) and not related to informedness of the patient. CONCLUSIONS: Patients had important information deficits when leaving the ED, and information transmission needs to be improved. The physician-patient discharge conversation seems an ideal opportunity for enhancing patient informedness. Standardisation of discharge procedures and training physicians in how to ensure that patients actually understand the information provided are needed.