Limitations of the study include the lack of education data on all patients as well as the exclusion of non-English speakers, the authors note. Researchers also didn’t give patients reading tests, relying instead on the highest level of education attained to estimate literacy skills.
Even so, the results highlight that patient discharge notes are currently written for education levels too advanced for many patients to understand, the authors conclude. To ensure patient comprehension, these notes should be written for a sixth grade audience.
“Careful design of discharge instructions, with input from patients themselves, would help us create more comprehensible tools,” says Dr. Kevin O’Leary, a researcher at the Northwestern University Feinberg School of Medicine in Chicago who wasn’t involved in the study.
It’s possible that electronic health records might be part of the solution, O’Leary added by email. These programs might allow doctors to assess how easily patients can read instructions in real time and prompt physicians to adjust their wording as needed to make it simpler to understand.
“Providing feedback for clinicians as they create the instructions would help them revise the wording to improve readability,” O’Leary says.
In addition, when patients or their families have trouble understanding their care instructions after getting home, they can still call the nurses’ station on the hospital floor where they were treated, or call their doctor’s office to ask questions.
