The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors.

To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of—and hence compliance with—discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON IMPLICATIONS OF HEALTH LITERACY FOR DISCHARGE INSTRUCTIONS
• ROUNDTABLE ON HEALTH LITERACY
• Reviewers
• Acknowledgments
• Acronyms
• 1. Introduction
  • ORGANIZATION OF THE SUMMARY
• 2. Overview of Issues Involved in Creating Better Discharge Instructions
  • DISCHARGE INSTRUCTIONS AND HEALTH LITERACY: POLICIES AND THEIR IMPLICATIONS
  • INPATIENT AND AMBULATORY DISCHARGE SUMMARIES
  • LINK BETWEEN HEALTH LITERATE AFTER-VISIT SUMMARIES AND DISCHARGE INSTRUCTIONS AND IMPROVED OUTCOMES
  • DISCUSSION
• 3. Inpatient Discharge Summaries
  • KEY ELEMENTS AND FORMATTING DISCHARGE INSTRUCTIONS
  • REACTIONS AND DISCUSSION
  • DISCUSSION
• 4. Outpatient After-Visit Summaries
  • VA LOMA LINDA HEALTHCARE SYSTEM AFTER-VISIT SUMMARY
  • REACTIONS AND DISCUSSION
  • DISCUSSION
• 5. Approaches to Developing Improved Discharge Instructions
  • PROJECT RED: REENGINEERING THE DISCHARGE PROCESS
  • DISCHARGE INSTRUCTIONS: PATIENT VALUES AND CHALLENGES
  • DISCUSSION
• 6. Reflections on the Workshop
• References
• APPENDIXES
  • Appendix A Workshop Agenda
  • Appendix B Biographical Sketches of Workshop Speakers

Rapporteurs: Joe Alper and Lyla M. Hernandez.

This activity was supported by contracts between the National Academy of Sciences and the Agency for Healthcare Research and Quality (HHSP233200900537P); California Dental Association; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Resources and Services Administration (HHSH25034004T); Humana; Johnson & Johnson; Merck and Co., Inc.; Office of Disease Prevention and Health Promotion; and UnitedHealth Group. The views presented in this publication are those of the rapporteur and do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

Suggested citation:

IOM (Institute of Medicine). 2014. Facilitating patient understanding of discharge instructions: Workshop summary. Washington, DC: The National Academies Press.

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.