Discharge Instructions

Ideally, ambulatory surgery patients should be given their discharge instructions during the preoperative conference in the office. A variety of patient education tools (e.g., pamphlets, detailed written instructions, and videos) may be used to help educate patients about their operations and subsequent postoperative care.38 Verbal reinforcement of written instructions by the surgeon is an important component of patient education. Communications from the surgeon should be consistent with the other materials (e.g., pamphlets, brochures, and preprinted instruction sheets) provided to the patient. The instructions the patient is given before leaving the ASC must also be consistent with what the patient or family has previously been told, whether orally or in writing, by the surgeon. Providing careful perioperative instructions can yield several significant benefits, including increased patient satisfaction, improved outcomes, decreased patient anxiety, improved compliance, and even reduced costs.45 In a multicenter British study, up to 25% of patients did not comply with postoperative instructions.46 There are several barriers to comprehension of or adherence to instructions that the surgeon must take into account.47 The most obvious barrier is that patients simply may not understand or remember the instructions given. It has been shown that patients' ability to understand written instructions may be a few grades lower than their actual education level48; accordingly, instructions should be written in such a way as to be easily understood by patients. In addition, patients may not be able to remember long, detailed verbal instructions well, even if they understood them on first hearing; thus, supplemental written instructions should be provided.

Table 12 Issues to Address in

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