Simplification of emergency department discharge instructions improves patient comprehension

Ann Emerg Med. 1995 Oct;26(4):443-6. doi: 10.1016/s0196-0644(95)70112-5.


Study objective: Emergency department patients have been shown to have difficulty understanding written discharge instructions. We attempted to determine whether improvements in comprehension can be achieved by simplification of available materials.

Design: We have previously tested patient understanding of standard discharge instructions. For this study, we simplified the standard instructions. Patients were given one of two simplified instruction sets. After reading the instructions, each patient was asked to answer five specific written questions about them. Results were compared with those from the original study.

Setting: ED of a large inner-city university hospital.

Participants: Four hundred twenty-three adult ED patients who presented on randomly selected days.

Results: The current and original groups were well matched for demographic variables. Each subject's responses were analyzed for overall success and for success with individual questions. The mean score for the current group was significantly improved over that of the original group. A trend toward improvement was demonstrated in all demographic groups with use of the simplified instructions.

Conclusion: Simplified written materials may help patients who do not understand current standard materials. Health care providers should simplify written materials to make them understandable to the greatest number of patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Educational Status
  • Emergency Service, Hospital / organization & administration*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Discharge*
  • Patient Education as Topic / methods*
  • Sex Factors