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50% of Patients Forget Treatment Plans, Need Better Patient Education

Patient education, strong patient-provider communication, and tools like whiteboards and patient portals will help patients recover information forgotten during inpatient stays.

Despite near-universal confidence, patients are forgetting most of the key information following an inpatient hospital stay, leading experts from the University of Michigan School of Medicine to call for wider use of patient education tools like patient-provider communication and patient portal access.

Only between 50 and 60 percent of patients remember key information from recent inpatient stays, including their diagnosis and even changes in medication regimens, the researchers wrote in The Joint Commission Journal on Quality and Patient Safety.

It’s a common refrain, but most of health happens outside the four walls of the hospital or clinic. To that end, strong levels of patient engagement and self-efficacy are key ingredients to good clinical outcomes.

“Patient education and engagement is considered a key component of transitional care efforts, leading to the development of standardized discharge instructions and patient-centered discharge tools,” Blair P. Golden, MD, MS, and Karen Okrainec, MD, MSc, FRCPC, wrote in an editorial accompanying the study.

But too often, patients don’t remember the instructions and notes they get from their providers. Particularly during an inpatient encounter, patients face an onslaught of information that can be difficult to digest and retain. Add to that the heightened stress an inpatient encounter can bring, and it may be challenging for patients to remember health information.

The UofM researchers found that this phenomenon is fairly common, even if 90 percent of patients included in the study said they were confident they could remember details from their inpatient stay.

After interviewing 53 patients one or two days following discharge from an inpatient encounter, the researchers found that patients need more support to remember the details of their encounters and post-discharge care management needs.

Just under 60 percent (58.5 percent) of patients could accurately remember the diagnoses addressed during the inpatient stay. Another 64.2 percent correctly recalled inpatient treatment, and 50.9 percent correctly recalled post-discharge treatment plans.

Even fewer patients (43.4 percent) correctly remembered any medication changes that happened during their inpatient stay, which could have serious patient safety implications down the line.

Healthcare providers are using some tools to ease patient education and help patients remember the details of their clinical encounters. More than 90 percent of patients said there were whiteboards in their rooms used to display medical information. However, patients said the whiteboards were the least helpful tools for helping them to retain information.

Instead, patients told the researchers that hospitals should provide paper and pens at the patient bedside so they or a family caregiver can take their own notes. It may also be helpful to reprioritize what information is displayed on the whiteboards, patients suggested.

Patients also mentioned patient-provider communication and the patient portal as being helpful for information retention.

Getting patients to remember what’s communicated during any clinical encounter is an age-old issue in healthcare. Patients are the sole proprietors of their healthcare outside the clinic or hospital’s four walls, so they need to be engaged in and well-informed about their diagnoses, treatments, care plans, and medication regimens.

This latest study indicates that the tools providers are already using to support patient education and engagement are falling short. Future studies should focus on which tools would be most helpful for closing the engagement gap between patients and providers.

“Health systems must proactively address disparities that exist with regard to patient and caregiver engagement surrounding care transitions, in addition to broader structural determinants of health that have been shown to contribute to health outcomes,” Okrainec said.

Correction 02/02/2023: A previous version of this article stated that the research was completed by experts at The Joint Commission. It was actually completed by experts from the University of Michigan School of Medicine.

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