A recent study suggests that most discharged emergency room (ER) patients are confident that they comprehend the treatment they received and the steps they should take to continue their care, but that in actuality most patients do not understand. 

According to this study, which was led by the University of Michigan Health System, three-quarters of emergency room (ER) visitors leave the ER with an understanding of their care and their treatment plan that contradicts ER team reports.

Emergency room patients typically have more serious injuries than patients who visit immediate care or urgent care facilities, but even patients with moderate injuries should be given extremely clear instructions to ensure comprehension. The study leaders suggest that the medical staff should invite questions, and should ask the patient to state in their own words what care they received and what their future care instructions are. 

The study involved detailed interviews with 140 English-speaking patients. Eighty percent of the patients in the study were convinced they had a clear understanding of their care, yet only 22 percent of the patient reports were very similar to what their ER care team reported. 

The researchers measured understanding of four areas: diagnosis, emergency care that was given, post-treatment steps, and what symptoms would warrant a visit to ER or an immediate care facility.

While this study measured ER patients, it is probable that some urgent care patients suffer a similar lack of comprehension. We’d all like to think that when someone says they understand a message, that they really understand it. There are many challenges to this process though. First, the person may be too proud to admit they do not comprehend, the medical staff might not create an environment that welcomes inquiry, and the patient may actually believe that they comprehend the medical experience adequately.

The best solution, it seems, is to speak slowly, simply, and clearly, to give written instructions whenever possible, and to offer the patient and/or their caregiver ample time for feedback. On a busy day this might not be possible, but when it comes to patients understanding their health, every bit of effort helps.

Sure, we’re on opposites sides of the pond, but residents of the United States and residents of England have a lot more in common than allegiance in World War II. Another link is that members of both countries are confused about which health scares are actual emergencies, and about who to contact.

A conservative member of the United Kingdom (UK) Parliament recently launched a consultation paper that suggests how the situation can be improved. Could his suggestions work in the United States?

The politician, Andrew Lansley, claims that the UK urgent care system is confused and lacks integration. In short, people aren’t sure what services to use. Lansley’s first suggestion is that patients ask themselves a simple question: Is my illness/injury an emergency?

If the person has an emergency, they should call the existing medical emergency number: 999, and should go to the emergency room. If the person does not have an emergency, they should call a new number, such as 116, Lansley suggested.

This new number would connect with urgent care providers and dentists, pharmacists and general practitioners who have extended hours.

Lansley wrote: "What matters is getting the right healthcare, at the right place, at the right time. That requires a clear system and a commitment to delivery, which has been sadly lacking to date."

Americans have the British equivalent of the 999 number, but could we also benefit from a number that connects patients with a service that could tell them where the nearest urgent care is, or that provides transportation to that facility?

These tactics probably won’t be explored stateside any time soon, but maybe our friends on the other side of the Atlantic can do the heavy lifting by trying the process out for us first.  

Physician entrepreneurs are usually independent and driven, but even the most tenacious doctor needs a little help sometimes. The Fifth-Annual today’s surgicenter Conference is offering an inaugural urgent-care track this year that will offer a wealth of information for urgent-care doctors and administrators.

The conference is Sept. 18-20, 2008, in Las Vegas. Education sessions include topics such as:

• Exploring business models in the urgent-care market
• IT-based business solutions
• Urgent care start-up 101
• Payment for services: cash vs. insurance

Several other topics will be discussed, such as marketing and retail clinics, and many urgent-care leaders have already signed up.

It’s exciting to be part of an industry that is still defining itself, but those waters can be murky. Conferences such as this are great for seeing the broad picture of your industry, accessing new ideas, and networking.

No doubt, it’s hard to find the time to leave a practice, but a thorough, cutting-edge conference can offer perspective and ultimately lead to an even stronger business. For more information on the Fifth-Annual today’s surgicenter Conference, visit www.surgicenterconference.com.