SHM Converge Scientific Abstract ePoster Gallery-Barriers to Patient Empowerment: Evaluating Literacy Level of Discharge Instructions

Pdf Summary

This study examined the readability, consistency, and language accessibility of discharge instructions in After Visit Summaries (AVSs) for 230 randomly selected hospital medicine patients at a large academic medical center. Because the AMA and NIH recommend patient materials be written at a 6th–7th grade reading level, the authors assessed whether current discharge instructions met that standard and whether content varied by provider type.<br /><br />The findings showed major gaps. Twenty percent of AVSs contained no unique provider-written discharge instructions at all. Among the instructions that did include free text, only 7% were written at or below a 7th grade level. The average readability was equivalent to about a 10th grade level, with substantial variability across documents. Reading level did not differ significantly by provider credentials or by hospitalist team.<br /><br />Content was also inconsistent. Diagnoses were included in 95% of instructions and medication changes in 68%, but important items such as diet, home monitoring, and patient restrictions appeared in fewer than 7% of cases. Language matching was another problem: many patients did not receive AVSs in their preferred language. Although translations were attempted for Spanish, Arabic, and Rohingya, only 35% of cases across the sampled languages were successfully translated.<br /><br />Overall, the study concludes that discharge instructions are often too complex, inconsistent, and not fully accessible to patients. The authors suggest future improvements such as templated discharge instructions, reminders to use short patient-friendly language, automated readability prompts, mandatory discharge instruction components, and better interpreter/translation support to improve patient understanding and empowerment after discharge.

Asset Subtitle

Meghana Patel

Meta Tag

Author List Fiona Thuy T. Chiu, Hillary L. Western, Meghana Patel, Samuel Porter

Category Research

Concept Discharge Instruction

Concept Readability

Concept Transitional Care

Concept Flesch-Kincaid Grade Level

Concept After-Visit Summary

Distinguished Non-Finalist

Presenter Organization University of Colorado School of Medicine

Presenting Author Meghana Patel

Track Transitions of Care

Keywords

discharge instructions

After Visit Summaries

readability

patient education

hospital medicine

language accessibility

translation support

provider consistency

medication changes

patient understanding

Discharge Instruction

Readability

Transitional Care

Flesch-Kincaid Grade Level

After-Visit Summary