John de Heide

Computer-generated patient-tailored discharge document 133 2.2 Discharge information Group I received the standardized discharge information booklet, as well as general verbal instructions, including the advice to consult the booklet in case of uncertainty concerning possible complications. Group II received the novel patient-tailored discharge information, which included a computer-generated document based on predefined variables (via check-boxes), as illustrated in Figure 1(a). The variables were derived from the analysis of two years of telephone patient follow-up data of 931 patients between 2010 and 2012, including patients discharged after the percutaneous electrophysiological intervention. Also, a small subgroup of 10 patients was surveyed to review an early version of the novel discharge information for lay-out and for the necessity of additional information. Minor alterations were done to the personalized discharge information afterward. The consequences of these various enhancements were that group II received both more specific and for some variables more extensive information than group I. The variables included clinical and procedural characteristics namely: type of ablation (relevant due to the number and diameter of used catheters), type of percutaneous access (arterial or venous), anticoagulation regimen and postprocedural bleeding or hematoma formation. Additionally, information on discharge medication (and dose), explicitly stating “altered, new or unchanged,” date of the outpatient appointment and whether cardiac rehabilitation is advised, were also provided. If necessary, additional information via free text could be entered. Importantly, a dedicated and secure server within the hospital IT structure was adopted to host the web-based tool. Based on this information, patient-tailored discharge information and instructions, consisting of one or two pages following a predefined format were printed (Figure 1(b)/1(c)). This document was dispensed to patients and used by healthcare providers to convey the discharge information uniformly and clearly, in addition to serving as a reference document for the guidance of patients after discharge. 2.3 Questionnaire The peer-reviewed questionnaire was based on the analysis of two years of telephone patient follow-up data of 931 patients between 2010 and 2012, including patients discharged after percutaneous electrophysiological intervention. This analysis revealed poor health literacy, poor retention of (provided) information and 8

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