HEARt Sounds: Audio Recordings to Improve Discharge Communication for Cardiology Inpatients

The proportion of eligible cardiology inpatients who agreed to take part in the research.

The proportion of cardiology inpatients in the intervention arm that received the audio recording intervention with full adherence to a pre-defined protocol fidelity checklist. Any deviations will be documented.

The proportion of discharged cardiology patients in the intervention arm who used the audio recording between the day of discharge and a one-week follow up telephone call initiated by the research team.

Measured using the Patient Activation Measure-13 (PAM-13). The PAM-13 is a 13-item survey that assesses a person's underlying knowledge, skills and confidence integral to managing his or her own health and healthcare. Each item is measured on a 4-point rating scale ranging from 1 (strongly disagree) to 4 (strongly agree). Scores for individual items are added to yield a sum score ranging from 0 to 100, with higher scores indicating greater self-management ability.

The proportion of patients in the intervention arm, compared to patients in the usual care arm, who report high confidence measured using an adapted version of the Health Confidence Measure that includes three response options; "very confident", "somewhat confident" and "not confident". Response options are categorized, with "very confident" indicating high health confidence vs. "somewhat confident" and "not confident" indicating low health confidence.

The proportion of patients in the intervention arm, compared to patients in the usual care arm, who report a high ability to understand health information measured using an adapted version of the Health Confidence Measure that includes three response options; "very understandable", "somewhat understandable" and "not understandable". Response options are categorized, with "very understandable" indicating a high ability to understand health information vs. "somewhat understandable" and "not understandable" indicating a low ability to understand health information.

Measured using the Medical Outcomes Study Measure of Adherence (MOS). The 5-item MOS measures general adherence to medical advice on a 6-point rating scale ranging from 1 (none of the time) to 6 (all of the time). Scores for individual items are averaged to yield a summary score ranging from 1 to 6, with higher scores indicating better adherence.

Measured using the Communication Assessment Tool (CAT). The 15-item CAT measures patient perceptions of physician performance in the area of interpersonal and communication skills using a 5-point rating scale ranging from 1 (poor) to 5 (excellent). The percentage of items scored as excellent is calculated as the percentage of items with a score of 5 (excellent) out of the number of items answered.

Measured using the Adherence to Refills and Medications Scale (ARMS-7). The 7-item ARMS-7 measures medication adherence and refill behaviors on a 4-point rating scale ranging from 1 (none of the time) to 4 (all of the time). Individual items are added and can be treated as a continuous measure or dichotomized as 7 or >7, with lower scores indicating better adherence.

The number of patient-generated post-discharge phone calls to the outpatient cardiology clinic or hospital emergency telephone line between the time of discharge and the research team's post-discharge follow-up telephone interview (both arms), according to data provided by the hospital's informatics team and the electronic medical record.