Patients’ awareness of their discharge diagnosis and follow up care in an Emergency Department. An intervention to improve discharge practices

Mrs Kelly Day1, Mr John Thomposon1,2, Professor Biswadev  Mitra1,3
1Alfred Hospital, Melbourne, Australia, 2La Trobe University School of Nursing and Midwifery, Alfred La Trobe Clinical School, Melbourne, Australia, 3Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia

Background: Effective communication between health professionals and patients during the discharge process ensures optimum post-Emergency Department management.  Inadequate patient comprehension regarding their healthcare results in poor health outcomes, reduced compliance and increased health resource usage.  Literature review findings found simplification of discharge material improves patients’ awareness of their discharge plan.
Aim: The research study aims are:

  1. To investigate patients’ current awareness of their discharge diagnosis and follow up plan to see a health professional under current standard care. Patients currently receive a written extensive two-page medical discharge summary including bloods and radiology results, medical assessment and follow up requirements with a Health Professional on discharge.
  2. To investigate if a simplified discharge information card in addition to current standard care can improve patients’ awareness of their discharge diagnosis and need for follow up appointment with a health professional.

Methods: The study is a separate pre-post samples design, a type of quasi-experimental study.  It involves two data collection stages, pre and post the intervention of the discharge information card.  In the first stage, interview data is collected from the control group who do not receive the discharge information card intervention.  The second data collection period occurs after implementation of the intervention.  Responses from all the interviews will be compared to the plan written in the medical notes and concordance recorded.  Outcomes of the cohort receiving the intervention will be compared to the control group.  The pre-and post-intervention groups consist of different participants.
Results: Preliminary findings from the Pre Intervention data demonstrate that 26% of patients did not know their discharge diagnosis and 46% did not know the plan to see a Health professional post discharge from the ED.  Post intervention data collection is still underway.
Conclusion: This research project is drawing to a close and formal results and conclusions are expected to be available in August, ready to present at ICEN.  Pre-intervention data already indicates the need for improvement in current protocol.


Kelly is a Clinical Nurse Specialist with five years clinical experience at the Alfred Hospital’s Emergency and Trauma Centre.  Kelly graduate from the University of Liverpool with a Bachelor of Nursing in 2008.  She is currently coordinating and undertaking this research study to submit for master’s thesis to implement an improved discharge communication tool for patients who are discharged home from the Emergency Department.