Efficient hospital discharge practices that prepare patients to transition to home are key to reducing readmissions and improving patients’ quality of life.Reference1 When done well, these practices can also increase patients’ overall satisfaction and confidence to function without hospital care, reduce feelings of vulnerability and enhance patient agency.
“I needed help when she was coming home,” says Juanna, a patient’s family member from Nova Scotia. “I needed help and I explained that to them very thoroughly. I received a call from the discharge pharmacist to go over my mom’s meds and I said ‘What do you mean, discharge?’ We were going to have a meeting to tell me what was going to take place and who was going to do what. She was being discharged in 2 days. I felt unprepared. Nothing had been in place. I didn’t know what exactly it was that they were going to do. I didn’t know she had to have needles for 2 weeks afterwards.”
The Information and Understanding When Leaving the Hospital patient-reported experience measure (PREM) can provide more insight into patients’ experiences during the discharge process. It provides information on whether patients had a clear understanding of their prescribed medications, whether they received enough information about what to do if they were worried about their condition or treatment, and whether they had a better understanding of their condition upon discharge.
Information and Understanding When Leaving the Hospital
| Province | Poor | Good | Very good | Number of respondents | |
|---|---|---|---|---|---|
|
Nova Scotia |
7% |
33% |
60% |
2,800 |
|
|
New Brunswick |
7% |
31% |
62% |
5,946 |
|
|
Ontario |
6% |
34% |
60% |
44,973 |
|
|
Manitoba |
7% |
35% |
59% |
10,933 |
|
|
Alberta |
4% |
33% |
63% |
21,870 |
|
Note
Data is shown for the most recent year of data submission (Ontario, Manitoba and Alberta, 2020–2021; New Brunswick, 2018–2019; Nova Scotia, 2017–2018).
52% of patients said that they had a better understanding of their condition when they left the hospital than when they entered.
74% of patients reported that they had a clear understanding about all of their prescribed medications before they left the hospital.
You can explore your hospital results in the Your Health System: In Depth interactive web tool, alongside other measures of hospital performance. Details about the Information and Understanding When Leaving the Hospital measure can be found on CIHI’s Indicators web page.
What other patient experience measures are strongly associated with this measure?
The following 3 key drivers have been identified for the Information and Understanding When Leaving the Hospital measure. A key driver is a patient experience measure that is strongly associated with or that influences results for this measure. Key drivers can potentially be used as areas of focus when planning quality improvement initiatives.
For more information on the methodology used in the key drivers analysis, please see Acute Care Patient-Reported Experience Measures — Methodology Notes. To learn more about CIHI’s other PREMs, see the Canadian Patient Experiences Survey — Inpatient Care: Patient-Reported Experience Measures.
Key drivers: Information and Understand When Leaving the Hospital
Received Information About Condition and Treatment
Whether patients felt they received all of the information they needed about their condition and treatment.
Emotional Support
Whether patients felt they were supported and helped with any anxieties, fears or worries during their hospital stay.
Internal Coordination of Care
Whether patients felt there was good communication between doctors, nurses and other hospital staff. This measure also looks at whether patients felt that hospital staff seemed informed about and up to date on their hospital care.
Digging deeper: The value of looking at patient experience with other health system performance indicators
PREMs improve our understanding of hospital visits and allow the patient voice to provide context on whether clinical aspects of care are meeting patients’ needs. When exploring health indicator results, like those found in the Your Health System: In Depth web tool, it’s important to consider patient experience together with other results. Considering other health system performance indicators with PREMs can help identify targeted and patient-centred opportunities for improvement.
For example, the Dryden Regional Health Centre uses patient experience data and service-level indicators to determine where there are opportunities to improve care.
Departmental reports are used by service leaders to examine and address opportunities to improve patient care across the spectrum from admission to discharge. Our health care system cannot work in silo without connecting all the contributing factors.— Katherine Campbell, Director, Risk, Quality, Safety, Dryden Regional Health Centre, Ontario
Other measures that could be considered alongside patient experience results are included in CIHI’s Your Health System: Insight tool, such as indicators focused on length of stay, wait times, hospital harms and readmissions.
What is the experience of patients readmitted to hospital?
Looking at additional measures like readmission through the lens of patient experience is important, especially if your facility has high readmission rates. For instance, readmissions and repeat hospital visits can be influenced by discharge factors such as patients receiving enough information upon discharge. At a national level, 57% of those who were readmitted to hospital reported that they were adequately prepared when leaving the hospital, compared with 60% of non-readmitted patients (readmitted n = 3,369; non-readmitted n = 85,507), a statistically significant difference.
Understanding the experience of patients who were readmitted can highlight ways to improve future communication between patients and care providers. By linking patient experience results with clinical factors, patients with poorer experiences can be identified so that initiatives can be developed to improve health outcomes, reduce costs and improve patient-centred care.Reference2
References
- 1.
- Back to Reference 1 in text
- Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013.
- 2.
- Back to Reference 2 in text
- Krist AH, Tong ST, Aycock RA, Longo DR. Engaging patients in decision-making and behavior change to promote prevention. Studies in Health Technology and Informatics. 2017.