A Piece of the Puzzle: Individualized Discharge Instructions for Firearm Injury Survivors

Firearm injury survivor (FIS) patients have complex care needs that are exacerbated by psychosocial factors, making them more likely to visit the emergency room within 30 d of hospital discharge. To address this disparity, a review of the discharge process was conducted with the goal of providing FIS patients with individualized care to maximize their recovery.

This multiphase quality improvement project was conducted at an urban level 1 trauma center from June 2022 to February 2024. The trauma discharge process was observed, and patients and providers were interviewed to identify areas of improvement. We found that patients and providers desired a brief, patient-centered document to clarify discharge instructions. In response, a customizable 1-page calendar template was created that includes a medication schedule, wound care tips, and follow-up appointment details. The tool was piloted for a group of FIS patients who were then surveyed about their perceptions compared to the standard after visit summary (AVS). A control group of FIS patients who did not receive the discharge tool were also surveyed.

Survey results (n = 25) found that 52.0% of patients reported using the discharge tool every day compared to only 28.0% who reported using the AVS every day. Among patients who did not receive the discharge tool (n = 25), 80% reported that they would have liked one.

Nearly twice as many patients reported using the customized discharge tool every day, suggesting greater ease of use compared to the AVS. This demonstrates that patient-centered discharge instructions are one important component of providing comprehensive care to FIS patients.