Ideas That Work: Improving Discharge Instructions

Practical pearls from your colleagues

The Ambulatory Surgery Unit at Kaiser Permanente Sacramento Medical Center performs outpatient surgeries encompassing various specialties and faces multiple daily challenges.

Challenges related to retaining information after surgery include cognitive impairment, anxiety and stress of patients due to anesthesia; the postoperative pain and discomfort patients are in; language barriers; and suboptimal healthcare literacy.

To improve the delivery of homecare recovery instructions, have patients remember the instructions better and to increase their overall satisfaction of their surgical experiences, the medical center instituted the following tweaks to its process:

• Educated staff during team huddles and department meetings.
• Added a colored coversheet to the homecare instructions.
• Carved out uninterrupted time after the preoperative process to discuss discharge instructions with patients and members of their support network.
• Reinforced discharge instructions at the bedside during post-op with the patient and their loved ones.
• Sent a physical copy of the instructions home with the patients and family members.
• Emailed an electronic copy of the instructions to each patient.
• Followed up the next day with a phone call to the patients or their caregivers.

The medical center’s satisfaction ratings increased after the changes, as did the patients’ likelihood of recommending the facility to others based on their experience.

A poster that highlights the initiative was exhibited at AORN’s 2025 Global Surgical Conference & Expo in Boston was authored by Kaiser Permanente’s Nancy Nguyen, BSN, RN II, and Franco Balitaan, MSN, RN IV, CPAN. “Efficient and effective discharge education is integral in improving patient care by ensuring that homecare and recovery instructions are understood and complied with by patients,” states the poster. “This project delineated useful strategies that can be adopted to enhance patient perception and retention of homecare instructions. Additionally, the interventions will help increase patient understanding, increase patient care experience and improve patient outcomes.

“Ultimately, the overarching goal of this project is to improve patient quality care and to improve the patient care experience.” OSM