Are healthy Veterans more health literate: Implementing a novel After Hospital Care Plan to Improve Patient Understanding and Facilitate Efficient Follow- Up Care at the Washington D.C. Veterans Affairs Medical Center

All too often, patients are discharged without a complete understanding of their medical plan. Patients also feel burdened with coordinating their own care which may contribute to dissatisfaction with their medical care. A new, comprehensive discharge booklet, hereby referred to as the After Hospital Care Plan (AHCP), was piloted at several Veterans Affairs medical facilities nationwide. Prior studies have shown the AHCP improves patient understanding of their medications, medical conditions, and importance of follow-up visits. The object of this study is to address barriers to implementation of the AHCP for medical floor patients at the Washington D.C. Veterans Affairs Medical Center (DC VAMC). Aim Implement AHCP on discharge for 25% of all patients cared for by medical teams by June 2017, while maintaining or improving patient satisfaction through progressive quality improvement cycles. Methods The software for the AHCP was tested multiple times on individually discharged patients to evaluate for technical barriers and to ensure that the AHCP would be accessible to all medical teams. The text and format of the AHCP booklet itself was also updated to ensure compliance with smoking/addiction counseling requirements. After technical success of the booklet was achieved, we developed educational materials for involved healthcare providers on how to use the new booklet. For monitoring of results, we selected several relevant inpatient satisfaction scores to assess improvements in patient understanding of their medical plan upon discharge Discussion We postulated that improving the vehicle of delivering health information to patients (the discharge booklet) would improve both patient comprehension and health outcomes. While many of our initial barriers were technical, many of the subsequent obstacles were related to redefining provider roles. Emerging technologies will continue to strive to make changes to established hospital processes and culture change is crucial to making way for newer and more efficient tools. The support of departmental leadership has been invaluable in garnering support from other departmental staff. Our next steps will be continuing to work with nursing and pharmacy staff to incorporate standardized training of the AHCP to be used for all patients being discharged from the medical floors. This project demonstrated the ease of implementing a new component of the discharge process among a small group of trainees within only a few months. We aspire to broaden education for all resident physicians to use the AHCP by the end of the academic year