title: Patient experience with discharge instructions in postdischarge recovery: a qualitative study.
abstract: We examined the role of discharge instructions in postoperative recovery for patients undergoing colorectal surgery and report themes related to patient perceptions of discharge instructions and postdischarge experience.
  
  
  
  Semistructured interviews were conducted as part of a formative evaluation of a Project Re-Engineered Discharge intervention adapted for surgical patients.
  
  
  
  Michael E. DeBakey VA Medical Center, a tertiary referral centre in Houston, Texas.
  
  
  
  Twelve patients undergoing elective colorectal surgery. Interviews were conducted at the two-week postoperative appointment.
  
  
  
  Participants demonstrated understanding of the content in the discharge instructions. During the interviews, participants reported several positive roles for discharge instructions in their postdischarge care: a sense of security, a reminder of inhospital education, a living document and a source of empowerment. Despite these positive associations, participants reported that the instructions provided insufficient information to promote access to care that effectively addressed acute issues following discharge. Participants noted difficulty reaching providers after discharge, which resulted in the adoption of workarounds to overcome system barriers.
  
  
  
  Despite concerted efforts to provide patient-centred instructions, the discharge instructions did not provide enough context to effectively guide postdischarge interactions with the healthcare system. Insufficient information on how to access and communicate with the most appropriate personnel in the healthcare system is an important barrier to patients receiving high-quality postdischarge care. Tools and strategies from team training programmes, such as team strategies and tools to enhance performance and patient safety, could be adapted to include patients and provide them with structured methods for communicating with healthcare providers post discharge.
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.|VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
authors.forename: Molly J
authors.initials: MJ
authors.lastname: Horstman
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Whitney L
authors.initials: WL
authors.lastname: Mills
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Jesse H. Jones Graduate School of Business, Rice University, Houston, Texas, USA.
authors.forename: Levi I
authors.initials: LI
authors.lastname: Herman
authors.affiliation: Internal Medicine Residency Program, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Cai
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: George
authors.initials: G
authors.lastname: Shelton
authors.affiliation: Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Tareq
authors.initials: T
authors.lastname: Qdaisat
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety (IQuESt); Michael E. DeBakey VA Medical Center, Houston, Texas, USA.|Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.|VA Quality Scholars Coordinating Center, IQuESt, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
authors.forename: Aanand D
authors.initials: AD
authors.lastname: Naik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000523:psychology* / Q000534:rehabilitation; D003142:Communication; D017558:Elective Surgical Procedures; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D061214:Patient Safety; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000592:standards*; D062606:Tertiary Care Centers; D013781:Texas
keywords: Care Transitions; Discharge Instructions