Personalizing discharge instructions with Sayvant

By Justin Mardjuki, CEO

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Given patients’ acute conditions in emergency medicine, it’s critical that clinicians deliver clear, personalized discharge instructions that meet each patient’s unique needs, language, and literacy levels. Personalized discharge instructions drive adherence, improve understanding, and accelerate patient disposition—outcomes that are essential in a high-speed emergency medicine setting.

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The Challenge

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Unfortunately, standard discharge instructions available in the EMR are typically one-size-fits-all for all patients falling under a particular diagnosis. We’ve all been victims of the Frankenstein discharge packet, which includes a few sentences from the doctor, a few pages of licensed content related to the diagnosis and disposition, and a QR code to download the patient portal.

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Studies indicate that up to 42% of patients do not receive complete discharge instructions, up to 56% of patients have poor understanding of their follow up appointment plans, and up to 64% do not understand their Return to ED (RTED) instructions (Sheikh et al., 2018, Karliner et al., 2012). These challenges are exacerbated by the 20%+ of patients in the US who do not speak English as their primary language at home (US Census, 2020).

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Personalized Instructions Improve Adherence

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For ED patients, adherence to discharge instructions can mean the difference between full recovery and repeat visits. Research consistently shows that tailored instructions yield better outcomes than standard versions. A systematic review and meta-analysis including a pooled analysis of 19 randomized clinical trials involving 3953 patients for the primary end point found that communication interventions at discharge were significantly associated with lower readmission rates, higher medication adherence, and higher patient satisfaction (Becker et al., 2020).

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Personalized instructions create accountability and empower patients to take charge of their recovery. By aligning with individual needs, they offer immediate, actionable guidance, which is crucial when consultation time is limited. This approach supports emergency clinicians in ensuring patients leave the ED equipped to manage their care effectively.

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Sayvant’s Unique Approach to Discharge Instruction Personalization

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Instead of increasing the library of pre-generated, ‘stock’ discharge instructions available, Sayvant generates personalized discharge instructions in real time, at the time of disposition.

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Sayvant leverages Large Language Models to create truly personalized discharge instructions. Sayvant analyzes the final chart to pull all of the available information available about the patient’s diagnosis and disposition. We then combine these key elements with clinically approved guidance, to assemble fully personalized discharge instructions that are unique to that patient’s encounter and clinician recommendation. All discharge instructions are written at a sixth grade health literacy level to maximize comprehension.

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The best part? Discharge instructions are not only personalized in English, but can be automatically translated into 35+ languages and dialects.

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Spotlight: D. Scott Moore, DO, MS, FAAEM, Henry Community Health

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“I had a pleasant surprise when preparing discharge instructions for an Arabic speaking patient last week. Sayvant recognized my description of the patient as being Arabic speaking, and translated my instructions into Arabic. Although our EMR could not print the Arabic Characters, I was able to directly print it from Sayvant for the patient who smiled broadly and said, “Oh Doctor, Arabic! Thank you!”

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Dr. Moore practices at Ascension St. Vincent Carmel in Carmel, Indiana in an Emergency Department seeing 15,000 patients per year.

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References

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Sheikh, H., Brezar, A., Dzwonek, A. et al. Patient understanding of discharge instructions in the emergency department: do different patients need different approaches?. Int J Emerg Med 11, 5 (2018). https://doi.org/10.1186/s12245-018-0164-0

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Karliner, L. S., Pérez-Stable, E. J., Gregorich, S. E., & Fernald, D. H. (2012). Language barriers and understanding of discharge instructions. Journal of Emergency Nursing, 37(2), 123-129.

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Becker C, Zumbrunn S, Beck K, Vincent A, Loretz N, Müller J, Amacher SA, Schaefert R, Hunziker S. Interventions to Improve Communication at Hospital Discharge and Rates of Readmission: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 Aug 2;4(8):e2119346. doi: 10.1001/jamanetworkopen.2021.19346. PMID: 34448868; PMCID: PMC8397933.

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