Assessing the Impact of Hospital Dismissal Summary Readability on Patient Outcomes Following Prostatectomy

• DOI: 10.1016/j.urology.2021.06.040
• Publication Date: 2021-07-22T18:29:15Z
• Authors: Madeleine G. Manka; Boyd R. Viers; Raevti Bole; Paige E. Nichols; Stephen A. Boorjian; Matthew K. Tollefson; Brian J. Linder
• Keywords: Prostatectomy; Patient Discharge Summaries; Middle Aged; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Outcome Assessment, Health Care; Humans; Comprehension; Aged; Retrospective Studies

To assess the impact of decreasing the reading level of hospital dismissal summary information on the number of unplanned patient contacts with providers following robot-assisted radical prostatectomy.A multidisciplinary team revised the hospital dismissal summary given to patients following prostatectomy to decrease the reading level from a 13th grade to seventh grade level. We conducted a retrospective cohort study comparing 30-day outcome measures including: patient-initiated telephone calls and online messages, unplanned clinic visits, readmission rates, and emergency department visits pre- and post-intervention. Other perioperative practices remained unchanged between the cohorts.A total of 110 patients were included in the study (pre-intervention n=60, post-intervention n=50). Patient age (P =.72), race (P =.59), marital status (P =.39), and education level (P = 1.0) were similar between the groups. Pre-intervention, 11.7% of patients had a self-reported education lever lower than the 13th grade, compared to 2% of patients post-intervention with an education level at or below the seventh grade. Following revision of the dismissal information, the number of patient-initiated messages (per patient) significantly decreased (mean 2.3 vs 1.4; P =.02). Patients who received the new dismissal information were significantly less likely to have an emergency department visit (20% vs 4%;P = .02). There were no differences in 30-day unplanned office visits (P =.75) or readmissions (P = 1.0).Reducing grade level readability of hospital dismissal information was associated with significantly lower rates of patient-initiated messages and emergency department visits. This intervention represents a valuable opportunity for improving the quality of patient care and decreasing postoperative care burden on the healthcare system.