Thumbnail Image

Improving Patient Discharge Satisfaction Scores by Implementing Teach-Back Instructions in a Community Hospital Emergency Department (ED): A Quality Improvement Project

Background: Health literacy and patient satisfaction play a role in healthcare today and it is the responsibility of all providers to ensure that patients are educated about the care they received in the ED and what they should be doing upon discharge. The teach-back method ensures patients have a complete understanding of their ED stay and discharge instructions. Purpose: The purpose of this quality improvement project was to increase patient satisfaction scores by implementing the evidenced-based, patient-centered, teach-back method for all patient education opportunities. Methods: The DNP student led the ED leadership team and staff nurses in a quality improvement project. The DNP student provided education on the use of teach-back and was a resource for the nurses who were expected to use the method. Using comparative analysis the DNP student compared the frequency distribution of the pre and post-intervention survey results and the de-identified EDCAHPS patient satisfaction scores from the three months before and after implementation. Results/Interpretation: There was a reported 7% to 18% increase in the nurses’ familiarity, use, comfort level and perceived sustainability of teach-back in the ED. There was an increase in the patient discharge satisfaction survey (EDCAHPS) scores of 3.96% for the five (5) questions addressing care and teaching by nurses during the ED stay and 6.525% for the four (4) questions related to the discharge process. Conclusion/Implications: Teach-back improved the quality of instructions provided in the ED leaving patients with the improved tools they need to care for themselves upon discharge. There was an improvement in patient discharge satisfaction scores which could lead to improved comprehension, compliance, better outcomes and decreased ED recidivism with complaints they have already been seen for. Teach-back was implemented as the appropriate method to use when providing patient education and discharge instructions in the ED. It will be reviewed with all new nursing staff members and periodically reinforced by the leadership team. Consideration will be given to providing the physicians, nurse practitioners and physician assistants the same instructions on how and when to use teach-back to improve the patient-centered care provided to all patients and family members in the ED.