Online Videos Complement Sunnybrook's Emergency Department Discharge Instructions

TORONTO, ONTARIO--(Marketwired - Nov. 20, 2013) - A new study in the journal PLOS ONE by Sunnybrook Health Sciences Centre researcher, Dr. Clare Atzema, and Sunnybrook colleagues Dr. Michael Brzozowski, Dr. Michael Feldman, Dr. Michael McDonnell, Libo Wu and Dr. Laurie Mazurik, has found that Emergency Department (ED) patients who viewed an online video of their discharge instructions had a much better understanding of key concepts around their diagnosis and subsequent care than those who did not.

Between November 2011 and January 2012, the researchers randomized Sunnybrook ED patients who were discharged with one of 38 diagnoses to either usual care, or to watch an online video with diagnosis-specific discharge instructions at home. Patients were later contacted by telephone and asked three key (standardized) questions about their discharge instructions. One point was given for each correct answer. A secondary outcome measure was patient satisfaction with the videos on a 10-point scale.

Among the 133 patients enrolled, the 58 patients who viewed a video were 3 1/2 times more likely to get a fully correct score than the group who received the usual discharge approach. The average satisfaction score for those who viewed the videos was 10.

Says Atzema, "Many studies have shown that the majority of patients leaving an ED are deficient in their understanding of one or more aspects of their discharge instructions. Our study shows that patients can learn and recall all of the key concepts of their instructions if those concepts are placed in an accessible video format."

The authors indicate that increasingly crowded EDs mean shortened doctor-patient interaction time. Crowding is known to affect academic centres in particular, where discharge instructions have been shown to average 76 seconds. This study suggests that using technology to deliver information on common discharge diagnoses (such as broken bone needing a splint or a cut requiring stitches) is a way to offset communication deficiencies related to lack of time in order to achieve patient understanding and retention of key discharge information.

Atzema, who is also a practicing Emergency physician at Sunnybrook, states, "There is definitely a need to develop innovations that can supplement standard care. Good discharge instructions could prevent subsequent hospitalizations and lessen repeat ED visits in an already overwhelmed system."

The results of the study are published in the November 2013 issue of PLOS ONE. The live article can be found here: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0077057.

The online videos of diagnosis-specific discharge instructions can be found here: Sunnybrook.ca/eddischarge.