Are discharge instructions understandable to the average patient

Many people may be surprised to learn that the American Medical Association has taken a rather firm position on the degree of difficulty with which patient health information — discharge instructions, etc. — should be drafted. Indeed, the AMA is of the belief that this information should be written for a sixth grade audience.

While this may seem like a questionable stance to some, the AMA argues that it’s entirely necessary given that almost 50 percent of the U.S. population can be classified as either functionally illiterate or marginally literate.

Interestingly enough, a recently published study in the American Journal of Surgery discovered that many physicians aren’t abiding by this recommendation, sending patients home from the hospital with discharge instructions/follow-up plans that are well beyond their comprehension level.

How was the study structured?

The researchers examined the discharge instructions/follow-up plans administered to 314 trauma patients, using two formulas based on the total number of syllables, words and sentences to assign them a reading level.

Among the patients who education information available, the majority possessed a high school degree, while 22 percent had completed some manner of college-level coursework. However, 40 percent were ultimately classified as marginally literate (6th-8th grade reading level) and 4 percent were ultimately classified as functionally illiterate (5th grade or below reading level).

What did the researchers determine?

The researchers found that in the majority of circumstances, the discharge instructions/follow-up plans were written at roughly a 10th grade reading level, meaning they required at least some level of high school education to understand.

Did this reality result in any negative patient outcomes?

It was determined that reading levels did not seem to directly affect the likelihood of patients either 1) calling the hospital with questions or 2) being readmitted within a month of discharge. However, they did determine that when either of these things happened, the patient in question typically read at a level considered too low to comprehend the discharge instructions/follow-up plans.

Why is this happening?  

The researchers theorized that one of reasons why discharge instructions/follow-up plans are not being written at the suggested 6th grade reading level is that physicians are failing to account for their audience, perhaps writing more for fellow physicians than their patients.

What can be done to help address this issue?

While the study authors simply urge greater vigilance on the part of physicians when drafting discharge instructions/follow-up plans, others unaffiliated with the study recommend taking things one-step further by having physicians draft discharge instructions during consults so that they could gauge patient comprehension in real time.

What are your thoughts on this study? Have you found your discharge instructions/follow-up plans were hard to follow?

If you’ve been seriously injured or lost a loved one because of medical negligence in any form, please consider speaking with an experienced legal professional as soon as possible.

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