Helping patients better manage post-hospital care

Being discharged from hospital following surgery can be a stressful experience. Patients are often anxious about their condition, making it difficult for them to grasp instructions from hospital staff on everything from taking medications to knowing when to go to medical appointments for follow-up care.

But a new tool recently adopted by Markham Stouffville Hospital (MSH) is designed to ease that transition, giving patients a set of clear and easy-to-understand instructions to follow upon discharge. That gives them greater confidence in their ability to take care of themselves and reduces the confusion experienced by many, says Mary Tang, a nurse practitioner in MSH’s surgical program.

The Patient Oriented Discharge Summary (PODS) was co-developed by patients and health-care providers and designed in collaboration with University Health Network’s OpenLab, a group dedicated to finding creative health-care solutions.

“We’re implementing the discharge program with all of our patients in the surgical program,” says Tang. “Anybody who has an in-patient stay with us receives a booklet that talks about what their experience will be like, beginning with who you will be seeing and what your room will look like.”

The benefits of improved transitions from hospital are many. According to research, they may lead to fewer re-admissions for patients, better medication adherence, improved health outcomes and greater confidence among patients in their ability to care for themselves.

Hospital discharge plans are usually written for doctors and other clinicians, not with the patient in mind. A report from the province’s avoidable hospitalization expert panel found communication of discharge instructions by hospitals was often poor because patients didn’t understand medical terms, weren’t fluent in English, weren’t able to memorize instructions or were too stressed at the time of discharge to absorb information.

Some patients might not receive any written discharge summary at all when leaving hospital. But PODS is completed with the patient and their family. Then, the patient is asked to recall and restate the instructions, in their own words, to ensure they understand. A traditional, more complex, discharge summary is still sent to the patient’s family doctor.

Eight hospitals tested PODS before the roll-out to 27 hospitals last year. At those test hospitals, patient understanding improved by 9.3 per cent to 19.4 per cent in the key areas covered by the PODS template: medication, danger signals, resumption of activities, who to call with questions and follow-up appointments. Overall, the hospitals found significant improvements in patient and provider experience.

Participating hospitals are now being encouraged to expand PODS use internally through more departments and to encourage other hospitals in their regions to use the tool.

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