Understanding and Execution of Discharge Instructions

Eric A. Coleman, Amita Chugh, Mark V. Williams, Jim Grigsby, Jeffrey J. Glasheen, Marlene McKenzie, Sung Joon Min

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Discharge from the acute care hospital is increasingly recognized as a time of heightened vulnerability for lapses in safety and quality. The capacity of patients to understand and execute discharge instructions is critical to promote effective self-care. This study explores factors that predict understanding and execution of discharge instructions in a sample of 237 recently discharged older adults. A study nurse conducted a postdischarge home visit to ascertain patient understanding and assess execution of instructions. Health literacy, cognition, and self-efficacy were important predictors of successful understanding and execution of instructions. Neither discharge diagnosis nor complexity of discharge instructions was found to be a significant predictor of these outcomes. Results indicate a need to implement reliable protocols that identify patients at risk for poor understanding and execution of hospital discharge instructions and provide customized approaches to meet them at their respective levels.

Original languageEnglish
Pages (from-to)383-391
Number of pages9
JournalAmerican Journal of Medical Quality
Issue number5
StatePublished - Sep 2013


  • care coordination
  • care management
  • discharge planning
  • hospital readmission
  • person-centered care


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