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David Mittleman
David Mittleman
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Discharge Miscommunication Common Between Medical Staff and Patients

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The other day, while standing in line at the pharmacy counter at a local hospital, I overheard a scary conversation between a case manager and a medical staffer. While waiting for the patient she was responsible for to finish his transaction at the pharmacy counter, the case manager put her hand to her mouth and whispered via a walkie-talkie to a medical staffer (clearly a nurse or doctor) that they had printed the wrong discharge instructions for the patient. That really got my mind to spinning–how many times does this kind of mistake occur? And do patients always notice when they get the wrong discharge instructions? What if those discharge instructions could mean the difference between life and death?

After doing a little bit of research on the topic, I discovered that miscommunication between ER physicians and outpatient doctors is common problem. In fact, one article detailed efforts by some doctors to stem the problem, as well as a study that provided evidence of the miscommunication that occurs. For example, in a study of 400 patients published in the Annals of Internal Medicine, researchers found that 19% of discharged patients experienced adverse effects after discharge. Unfortunately, nearly half of those events could've been prevented through adequate communication between hospital caregivers and outpatient doctors or patients.

Apparently, this problem isn't as uncommon as I would've hoped. However, there are ways to prevent the problem. One medical blogger goes as far to say that pre-printed discharge instructions are overall useless and that doctors should take the time to handwrite instructions for their patients and go over them before the patient exits the hospital to ensure that they understand. Specifically, doctors can 1) give a specific time and place for follow-up such as see your general practioner by Tuesday next week; 2) give specific cues of when to return to the ER such as if the patient experiences vomiting, dizziness, etc.; 3) gives the simple message that if the patient is worried or thinks something is wrong, that they should return to the ER right away. Writing these specific and simple instructions for an individual patient minimizes the patient's risk and reduces the risk of printing off the wrong instructions.