How much is too much?

I have always wonder how much information a patient can handle before it is too much. In many occasions, I can see the multiple handouts given to the patients when discharge from the hospital due to an exacerbation. But, when asked what happened, or if there were any changes to medication, the answer for the most part is the same: “they did not tell me anything”; or ” I do not know”.

For example, a discharge summary given to the patient, contains a minimum of three pages, it describes the condition, instructions as to when to call the primary care provider, a list of the medications to continue taking, if any, and names and numbers of the providers that a the patient needs to follow up; however, those handouts are placed in the bag when leaving the hospital and never read; it is unlikely the patient would made the follow up appointments, resulting in patients falling through the cracks and having incomplete care. I think that when educating a patient the information must be concise, in small badges, and face to face. For instance, a patient with diabetes and hypertension, how he is predisposed to a higher risk for chronic kidney disease if blood pressure and glucose are out of control. In the clinical setting where I work, we use a team approach to support patients needs and increase quality of life. I think that all patients need to understand their options to improve clinical outcomes. Educating patients is not a simple task, handing papers or reminding patients to take their medications and follow their diets; it goes beyond that, a patient that understands the disease process and participates in the plan of care will achieve better outcomes.

With that in mind, I started giving small amounts of information, for instance, when reviewing hemoglobin A1c patients see the numbers, yet, the importance of the number is barely explained, if they understand the value of the number life-style changes would take place. Also, a long list of changes is not appealing to most patients, but stepping up makes more sense. Salt is very difficult to cut from our food, so, instead of telling the patient to eat with less salt, I suggest to get rid of the salt shaker on the table; this will reduce the additional salt that is placed on their food.

Our patients need more from us that just instructions, they deserve time to understand their diagnosis, so that they are willing participants of their plan of care.