• Stefanie Simmons, Brian Sharp, Jennifer Fowler, Hope Fowkes, Patricia Paz-Arabo, Mary Kate Dilt-Skaggs, Bonita Singal, and Thomas Carter.
• St. Joseph Mercy Hospital, Department of Emergency Medicine, Ann Arbor, USA. Electronic address: ssimmons@epmg.com.
• Patient Educ Couns. 2015 Feb 1; 98 (2): 257-62.

ObjectivesWe developed a communication instrument to be used in the Emergency Department (ED) and hypothesized that use of this guide would increase patient comprehension of and satisfaction with care.MethodsThis multi-site trial enrolled 643 patients in treatment and control groups. Comprehension of care was assessed by chart review and satisfaction measured via validated survey.ResultsUse of the instrument was not associated with improvements in patient knowledge about their care, with a mean of 4.6 (95% CI: 4.8-5.8) comprehension defects in the control group and 4.4 (95% CI: 3.9-4.9) in the treatment group. There was no significant effect on patient satisfaction 76.4% versus 76.9%, p=0.34. Elderly patients in both groups were found to have 1.1 (p<0.01) more knowledge gaps than younger patients.ConclusionPatients frequently misunderstand medical care in the ED. Comprehension decreases with increasing age. An isolated communication instrument does not improve satisfaction with or understanding of the care received.Practice ImplicationsProviding a structured place for providers and patients to record details of care does not seem to improve satisfaction with or comprehension of care. Interventions that focus on communication skills and face time with patients may prove more effective.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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