title: Automated pictographic illustration of discharge instructions with Glyph: impact on patient recall and satisfaction.
abstract: First, to evaluate the effect of standard vs pictograph-enhanced discharge instructions on patients' immediate and delayed recall of and satisfaction with their discharge instructions. Second, to evaluate the effect of automated pictograph enhancement on patient satisfaction with their discharge instructions.
  
  
  
  Glyph, an automated healthcare informatics system, was used to automatically enhance patient discharge instructions with pictographs. Glyph was developed at the University of Utah by our research team. Patients in a cardiovascular medical unit were randomized to receive pictograph-enhanced or standard discharge instructions. Measures of immediate and delayed recall and satisfaction with discharge instructions were compared between two randomized groups: pictograph (n = 71) and standard (n = 73).
  
  
  
  Study participants who received pictograph-enhanced discharge instructions recalled 35% more of their instructions at discharge than those who received standard discharge instructions. The ratio of instructions at discharge was: standard = 0.04 ± 0.03 and pictograph-enhanced = 0.06 ± 0.03. The ratio of instructions at 1 week post discharge was: standard = 0.04 ± 0.02 and pictograph-enhanced 0.04 ± 0.02. Additionally, study participants who received pictograph-enhanced discharge instructions were more satisfied with the understandability of their instructions at 1 week post-discharge than those who received standard discharge instructions.
  
  
  
  Pictograph-enhanced discharge instructions have the potential to increase patient understanding of and satisfaction with discharge instructions.
  
  
  
  It is feasible to automatically illustrate discharge instructions and provide them to patients in a timely manner without interfering with clinical work. Illustrations in discharge instructions were found to improve patients' short-term recall of discharge instructions and delayed satisfaction (1-week post hospitalization) with the instructions. Therefore, it is likely that patients' understanding of and interaction with their discharge instructions is improved by the addition of illustrations.
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA b.hill@utah.edu.
authors.forename: Brent
authors.initials: B
authors.lastname: Hill
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Seneca
authors.initials: S
authors.lastname: Perri-Moore
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Jinqiu
authors.initials: J
authors.lastname: Kuang
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Bray
authors.affiliation: Harvard School of Medicine, Harvard University, Boston, MA, USA.
authors.forename: Long
authors.initials: L
authors.lastname: Ngo
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Alexa
authors.initials: A
authors.lastname: Doig
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zeng-Treitler
mesh_terms: D000328:Adult; D000368:Aged; D001296:Audiovisual Aids; D004522:Educational Status; D005260:Female; D057220:Health Literacy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008488:Medical Illustration; D011939:Mental Recall; D008875:Middle Aged; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction
keywords: consumer; health literacy; informatics; patient education; pictograph