The impact of teach-back on comprehension of discharge instructions and satisfaction among emergency XXXX with limited health literacy: A randomized, controlled study.

@entity1 @entity341
OBJECTIVE: Recommended as a 'universal precaution' for improving provider- @entity1 communication, teach-back has a limited evidence base. Discharge from the @entity341 ( @entity341 ) to home is an important high-risk transition of care with potential for miscommunication of critical information. We examined whether teach-back improves: comprehension and perceived comprehension of discharge instructions and satisfaction among @entity1 with limited health literacy (LHL) in the @entity341 . METHODS: We performed a randomized, controlled study among adult @entity1 with LHL, to teach-back or standard discharge instructions. @entity1 completed an audio-recorded structured interview evaluating comprehension and perceived comprehension of (1) diagnosis, (2) @entity341 course, (3) post- @entity341 care, and (4) reasons to return and satisfaction using four Consumer Assessment of Healthcare Providers and Systems questions. Concordance with the medical record was rated using a five-level scale. We analyzed differences between groups using multivariable ordinal logistic regression. RESULTS: @entity1 randomized to receive teach-back had higher comprehension of post- @entity341 care areas: post- @entity341 medication (P < 0.02), self-care (P < 0.03), and follow-up instructions (P < 0.0001), but no change in @entity1 satisfaction or perceived comprehension. CONCLUSION: Teach-back appears to improve comprehension of post- @entity341 care instructions but not satisfaction or perceived comprehension. Our data from a randomized, controlled study support the effectiveness of teach-back in a busy clinical setting. Further research is needed to test the utility and feasibility of teach-back for routine use including its impacts on distal outcomes.
