Improving Patient Understanding and Experience at Discharge in General Surgery: A Clinical Audit from a Rural District Hospital in Central India

Abstract Background: Effective discharge communication is essential for ensuring patient understanding, treatment adherence, and continuity of care in general surgery. However, in high-volume rural district hospitals, limited consultation time and heavy patient loads may compromise the clarity of information delivered at discharge. This clinical audit aimed to evaluate patient understanding and experience during discharge from general surgery services and to determine whether a brief structured verbal communication approach could improve these outcomes. Methods: A prospective before–after clinical audit was conducted in the Department of General Surgery at a Rural District Government Hospital in Central India. Consecutive adult patients discharged from outpatient and emergency surgical services were included. Patient understanding and experience were assessed using a structured five-item verbal questionnaire addressing understanding of diagnosis, treatment rationale, medication instructions, follow-up advice, and perceived clinician attentiveness. A baseline audit of 150 patients was performed. Following the implementation of a structured verbal discharge communication approach, a re-audit was conducted among an additional 150 patients. Results: Baseline findings demonstrated substantial gaps in patient understanding, particularly regarding treatment rationale and follow-up instructions. After implementation of the structured communication approach, patient-reported understanding improved across all assessed domains. Overall discharge comprehension increased from 44% at baseline to 82% in the re-audit phase, with the greatest improvement observed in understanding of follow-up instructions. Conclusion: A simple, low-resource structured verbal communication approach significantly improved patient understanding and experience at discharge in a rural general surgery setting. Such interventions may support safer transitions of care and could be easily implemented in similar resource-limited healthcare environments.