ER Patients Left Clueless

September 19th, 2008 | Sources: NY Times

A study published in the Annals of Emergency Medicine found that the majority of patients who are discharged from emergency rooms leave with little understanding of what happened to them in the ER and what they are supposed to do to take care of themselves after returning home.

Investigators tracked 140 patients discharged from the ERs of two Michigan hospitals to determine whether they understood their diagnosis, treatment, home-care instructions and a list of signs which signified the need for immediate follow-up.

78% of the patients did not understand of at least one of these four areas, and half didn’t understand at least two of them.

The biggest problem was home-care instructions, things like when and how to take medications, activity limitations, wound care and the need for follow-up.

The communication breakdown often caused medication errors and complications necessitating return trips to the ER and even hospital admission.

ERs are a set-up for poor doctor-patient communication. Physicians are busy with multiple patients including some who are quite ill, and patients are distressed by the condition prompting their visit.

Experts suggest two strategies to reduce these errors. The first is a teach-back method in which a patient, ideally while accompanied by a friend or relative, repeats instructions to the physician. The second is a dual-discharge method in which a nurse follows up with patients after physicians discharge them.


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