4 Discharge Disconnects and What to Do About Them


patient in wheelchair
A new study
in JAMA Internal Medicine found that patients discharged from a large academic medical center think they understand everything when they are released, but then have several gaps in what they remember when they return home.

Some highlights from the study show the “discharge disconnects:”

  • 60% could accurately describe their diagnoses, 35% had trouble explaining why they were in the hospital
  • Less than a third reported learning about their discharge more than a day in advance
  • About half of patients thought their doctors scheduled a follow-up appointment, when actually only 33% had one scheduled
  • A quarter of the discharge instructions used medical jargon like “myocardial infarction” instead of patient-friendly language like “heart attack.”

Lots of “little things” can help here. Earlier this month, nurses at NYU Langone Medical Center reported that their after-discharge phone calls reduced heart failure readmissions rates to 16%, compared to the national rate of 25.9%.

An editorial in this month’s JAMA, “Treat Me Like A Child,” proposes that the overall hospital industry can learn from their own pediatric establishments. Create soothing environments, have patient-centered care conversations, and add a bit of whimsy to the mix. I think this thought process can also be brought to discharge planning:

  • Speak to patients in easy to understand terms.
  • Like a child who has to do their household chores, remind them of their responsibilities once they return home.
  • Perhaps most important, include a caregiver in the process that can help the patient will all they need to do.

A guided online program – for patients and their families – can provide many of these benefits without the labor-intensive need for nursing or social work phone calls. Learn how pro-active discharge planning and reinforced discharge instructions can compress the hospital discharge process and reduce length of stay in this article: “The Top 3 Pains of the Hospital Discharge Process and How to Solve Them.”


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