2024 SAEMF/RAMS Resident Research Grant - $5,000

"Improving the Emergency Department Discharge Process for Older Adults: The GET HOME Safe Discharge Intervention"

Effective communication of discharge instructions and follow-up recommendations is critical at the time of discharge from the emergency department. During this time patients are educated on important items such as the diagnosis or the diagnostic uncertainty, tests that were performed in the emergency department, both medication and non-medication treatments at home, medications to avoid, and recommendations for follow-up. Substantial evidence suggests that patients often have difficulty understanding discharge instructions, particularly elderly patients who often have more complex management plans. Direct observations and audio recordings suggest these conversations are frequently incomplete and omit checks for patient understanding. Furthermore, when discussing discharge plans with a patient, physicians too often do not account for how barriers to follow-up, such as transportation or lack of primary care, will be surmounted. Qualitative interviews with patients report that a portion of return visits are related to incomplete information at the time of discharge and interviews with caregivers of older patients highlight that a clear plan for follow-up care is a top priority. Despite the discharge process being an essential and high-risk component of the emergency visit, training on this “procedure” is often overlooked during emergency medicine residency. There is a substantial need for an effective patient-centered teaching tool to enhance residency training on the essential components of the discharge conversation. The goal of this project is to develop, implement, and evaluate the impact of a standardized conversation tool for emergency medicine residents to facilitate a high-quality discharge conversation for patients and their caregivers.