Healthcare News & Insights

Why assessing patients’ health literacy may improve discharge process

For a smoother patient recovery post-discharge (and to reduce the chance of readmission), it’s helpful to cater discharge instructions to each patient’s level of basic health literacy.

Doctor explaining to PatientHere’s why: A new study showed that nearly half of patients who stayed in the hospital for heart-related issues didn’t fully understand their discharge instructions or their medication schedules, something that could land them right back in the hospital.

And this may be due to communication gaps caused by varying levels of health literacy.

According to an article from Reuters Health, researchers studied close to 500 people across the country who were recently discharged after staying in the hospital for heart problems, such as heart attacks and heart failure. Each person was asked to take a test measuring health literacy skills.

Then, patients were asked about the medications they were taking.

Researchers compared patients’ answers with data from their discharge lists, looking for errors such as:

  • forgetting to mention a drug on the list
  • mentioning a medication that wasn’t on the list
  • forgetting to refill a prescription, and
  • discontinuing use of a medication against doctor’s orders.

The researchers also looked at whether patients understood the purpose of their medications, asking them if they knew why they were taking a certain drug, or how often they had to take it.

Incomplete knowledge

The study’s findings weren’t encouraging.

Over half of the patients had an issue where the medications they said they were taking didn’t match up with the ones on their discharge list. More than 25% didn’t mention medications that were on their discharge instructions. And over a third of patients were taking drugs that weren’t on their lists at all.

Worse, nearly 60% of patients had some sort of misunderstanding about the purpose, frequency or dosage instructions for their medications.

Those who fared better in this study had a stronger sense of health literacy. Patients with the highest health literacy scores were 16% less likely to make mistakes with their medications. Female participants fared better than men – they were 40% less likely to make errors.

People who were more likely to make medication errors: Single people (who had almost a 70% higher chance of making mistakes than married people), elderly people and those with lower cognitive functions.

How to assess health literacy

With readmission rates for heart problems being on Medicare’s hit list for hospitals, it’s important for clinical staffers to do whatever they can to keep patients’ recovery free of complications. That includes giving them discharge instructions they can easily understand and follow.

To help with this process, you may wish to ask staffers to conduct a quick, basic assessment to judge patients’ level of health literacy before they’re discharged. That way, staff members can adjust their communication style to fit the person’s knowledge, cutting down on confusion.

One quick assessment tool that’s been used with success in a variety of clinical settings is the Newest Vital Sign, a three-minute test designed by Pfizer that helps healthcare professionals determine a person’s health literacy. Patients are asked to interpret info on an ice cream label, and by scoring their results, staffers can figure out the best way to talk to them about their treatment.

Taking this extra step to ensure patients understand their discharge instructions is a win-win for everyone. If patients know how to take care of themselves after leaving the hospital, they’re less likely to return – which means your hospital may avoid penalties from Medicare.

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