Emergency department discharge instructions: a wide variation in practice across Australasia

Objectives-All patients discharged from the emergency department (ED) shoul d be given discharge instructions (DIs). This study aimed to describe the D I practices of EDs in Australasia and to examine the differences between pu blic and private EDs. Methods-A voluntary, questionnaire-based survey of public and private EDs t hroughout Australia and New Zealand. Results-58 of 74 (78.4%) EDs provided instruction notes upon discharge alth ough 51 (68.9%) gave them to only "some" patients. There were no significan t differences between the public and private EDs (p>0.05). Thirsty seven (5 0%) EDs provided pre-formatted instruction sheets although 22 (29.7%) EDs g ave them to only "Some" patients. There were no significant differences bet ween the public and private EDs (p>0.05). Only five (6.8%) EDs retained a c opy of the instruction sheets and no (0%) ED provided sheets that included all recommended features. Sixty six (89.2%) EDs provided information sheets although 44 (59.5%) EDs gave them to only "some" patients. Private EDs gav e information sheets to significantly more patients than public EDs (p=0.04 ). Conclusions-The DI practices of individual EDs varied and the rates of DI p rovision were low. EDs should improve their DT practices. Pre-formatted ins truction sheets, containing all recommended features, should be provided to all patients with a copy kept in the medical record. Consideration should be given to the use of DI practices as an ED performance indicator.