Friday, February 10, 2012

The Value of Discharge Instructions

The purposes of discharge instructions are:

  • To provide time-specific follow-up with the appropriate family physician or specialist
  • To  convey to the patient and/or family some knowledge of the probable disease or injury process
  • To list prescriptions and treatments given
  • To establish a layer of medical-legal protection for the practitioner 

At minimum, instructions need to be legible, and so are best computer generated and printed.

Unfortunately, however, unintended consequences of these efforts have evolved into a complex morass of endless paperwork.  As a result, the patient now receives a bundle of pages equivalent to a small textbook, containing more information than most people can realistically comprehend, including drug interactions, side effects, multiple contingency plans, and complex symptom sets to watch for.

The KISS (Keep It Simple Stupid) principle should predominate.  

Most importantly, the patient and family need to know that he/she should comeback, or be brought back, immediately if there is any deterioration or if new symptoms have developed. This bottom-line principle message needs be stated concisely in fourth grade level language, using large readable letters.