Patient-perceived value of a specialty-specific welcome letter: What you say and how you say it.

Background: Patient experience and clinical outcomes are improved when patients know what to expect. Providing valuable, appropriate information proves challenging considering variation in patient education, literacy, and limitations specific to patients with neurologic disease. Scaffolding of what to expect, care team members, needed materials, procedures, directions to facilities, and methods of communication are core aspects of improving patient readiness.

Methods: This study employed standard quality improvement methods. An existing (original) patient welcome letter was first analyzed to assess its literacy levels. Surveys were then administered to patients with neurologic disease assessing perception of readiness for ambulatory appointments and the overall value of the welcome letter. In addition to Likert-type scales, patients also provided open feedback on what should be included in the letter. A revised letter was then created with added content, improving literacy levels. The letter was further assessed through clinical and nonclinical groups including our neuromedicine Patient and Family Advisory Council. Response data were analyzed comparing the original vs the revised score using a test assuming equal variances.

Results: The "overall value" score of the original welcome letter (3.79 of 5.0) improved to the revised score (4.63 of 5.0). Patients perceived the revised welcome letter as improving their readiness significantly as ambulatory patients with neurologic disease.

Conclusions: Preparing patients for their neurology visits is important and affects visits' value. Sensitivity to literacy levels is an essential component of person-centered care among neurologic patients. Carefully created and assessed welcome letters help to achieve these goals by improving readiness for outpatient appointments and increases perceived overall value significantly.