Using video discharge instructions as an adjunct to standard written instructions improved caregivers' understanding of their child's emergency department visit, plan, and follow-up: a randomized controlled trial.

OBJECTIVE: Previous studies demonstrate that patients often have difficulty understanding their discharge instructions. Video discharge instructions have the potential to mitigate factors such as illiteracy and limited physician time, which may affect comprehension. Our goal is to determine if adding video discharge instructions affects caregivers' understanding of their child's emergency department (ED) visit, plan, and follow-up.

METHODS: Caregivers of patients, aged 29 days to 18 years, with a diagnosis of fever, vomiting or diarrhea, and wheezing or asthma were randomized into written or video discharge instruction groups. In the ED, caregivers read standard written discharge instructions or watched a 3-minute video based on their child's diagnosis. They were then asked questions regarding information covered in these instructions. After completing the 20-point questionnaire, standard discharge procedure was followed. Caregivers were contacted by phone 2 to 5 days after discharge for a follow-up questionnaire. Usefulness of the discharge instructions was also assessed.

RESULTS: Of 436 caregivers enrolled, 220 received written and 216 received video discharge instructions. The follow-up questionnaire was completed by 341 caregivers. The group receiving video discharge instructions scored significantly higher in the ED (12.2 vs 8.9) and 2 to 5 days after discharge (11.1 vs 7.8). At follow-up, 29% of the written and 42% of the video groups rated their discharge instructions as being extremely helpful.

CONCLUSIONS: Brief video discharge instructions improved caregiver knowledge both in the ED and 2 to 5 days after discharge compared with written discharge instructions alone. Caregiver satisfaction with video discharge instructions was also greater than with written discharge instructions.