Sidney University. Australia: A simply-worded letter that is directed at the patient and given to
them prior to discharge from hospital can immediately improve their
knowledge and understanding of their in-hospital tests and
post-discharge recommendations, University of Sydney research reveals.
Published
in the Internal Medical Journal, the study found that while patients
knew why they went into hospital, they had very little understanding of
the tests performed while there, and recommendations for what to do when
they go home.
"Patients can often be anxious, and this may
interfere with their understanding and recall of what has happened in
hospital and what the required follow-up is," said senior investigator
of the study Professor Geoffrey Tofler, Preventative Cardiology at University of Sydney, and Cardiologist at Royal North Shore Hospital.
"Discharge
summaries are typically written for the doctors not the patient, so
often use complex medical terminology that the patient doesn't
understand. The end result is that recommendations are often discarded,"
Professor Tofler said.
"This lack of understanding when patients
make the transition from the hospital to the community can lead to
health problems including an increased need for re-hospitalisation."
In
the study, patients were given a brief one-page letter that was written
in simple language that summarised their hospitalization - the letter
was then discussed with the patient.
The PADDLE letter was divided into four sections:
- The reasons for hospitalisation (symptoms and diagnosis)
- Tests and results whilst in hospital
- Treatments received in hospital
- Recommendations once discharged from hospital
"Our
results found that the letter was well received by the patients, with
93 per cent rating it very helpful or helpful," said Professor Tofler.
"Patients
leaving hospital after receiving the discharge letter are much better
informed about their medical condition and their role in the critical
early period post-discharge."
Tony Spencer, a patient recipient of
the PADDLE letter said that "I found Dr Tofler's patient letter
extremely helpful when I left hospital after being treated for a heart
condition.
"Being succinct and personally written it served as a
quick checkpoint to assure me that I am following the right course of
action.
"The letter covered my follow up appointments,
medications, and reinforced the need for lifestyle changes such as
quitting smoking. It also explained the heart scan I had while in
hospital as I had been unable to get information on the outcome prior to
that.
"Without doubt, the patient letter will result in more people following their prescribed recommendations," Mr Spencer said.
"The
patient discharge letter only takes 5-10 minutes to write (completed by
the patients' doctors) with the contents explained to the patient at
their bedside," said Professor Tofler.
"This is a small change to
practice that could make a large difference in patient's lives, and
could prevent subsequent hospital readmissions and their associated
costs.
"Interventions that improve understanding for the patient
and their families are becoming increasingly important, and together
with more rigorous discharge planning and post-discharge patient
education, we can improve outcomes.
"The PADDLE letter deserves further evaluation and consideration for integrating into routine discharge practice," he said.
Study
authors were: Raymond Lin, Robyn Gallagher, Monica Spinaze, Hadi
Nojoumian, Christopher Dennis, Roderick Clifton-Bligh, and Geoffrey
Tofler.
Media enquiries: Kobi Print 0481 012 729, 9036 7589, kobi.print@sydney.edu.au