Stop Blaming Patients. Start Designing for Them—and Watch Your ROI Improve

Instead of spending more on ways to answer patient questions, how about reducing the need for so many questions in the first place?

By C, Anthony Jones

In health care, when patients miss a step, call with questions, or don’t follow instructions, the blame often falls on them: “They weren’t paying attention.” “They didn’t read what we gave them.” “They weren’t motivated.”

But the real problem isn’t the patient. It’s the design.

Most patient instructions today aren’t built for understanding. They’re built for compliance—dense, transactional documents optimized to check legal boxes, not to support people navigating complex and often frightening moments in their lives.

The result? Patients are confused, and systems absorb the cost: avoidable phone calls, delayed procedures, unnecessary complications, and staff time spent untangling issues that never should have occurred.

And all of that has a measurable financial impact.

The Cost of Clarity Gaps
When instructions aren’t clear, the downstream effects can be costly:

• Cancellations and no-shows disrupt OR and clinic schedules.
• Pre-op errors lead to delays or rescheduling.
• Post-op confusion results in non-adherence, higher readmission risk, and avoidable complications.

A multicenter study of outpatient surgical patients found that patients with low health literacy were significantly less likely to comply with preoperative instructions, leading to procedural delays and cancellations (1).

Meanwhile, the 2003 NAAL—the most comprehensive U.S. health literacy assessment—revealed that only about 12% of adults have proficient health literacy, while over one-third scored in the basic or below-basic range (2).

These may show up as clinical problems—but the causes are operational. Every rescheduled surgery or extended phone call adds friction and costs money.

Time Is Money—Especially for Staff
Administrative staff and nurses often bear the brunt of poor instructional design. When instructions are unclear, the phones light up while portal messages and emails rush in. And while patient calls are important, most health systems don't have enough staff to keep absorbing work that shouldn’t exist in the first place.

Unnecessary calls pull attention away from more urgent (and profitable) clinical tasks and fuel burnout—already a major issue among health care workers. In large practices and health systems, even modest improvements in communication design can reclaim hours of staff time every week.

And that time is valuable. Whether it’s being redirected to higher-value clinical care, new patient intake, or reducing overtime, it contributes directly to both patient experience and staff retention—key drivers of systemwide performance and Star ratings (3).

Patient Experience Is Operational Strategy
Clearer communication doesn’t just reduce friction. It improves satisfaction, which has direct revenue implications. CMS Star ratings, value-based reimbursement models, and online reputation all hinge in part on how well patients feel informed, supported, and respected.

In this context, “clarity” isn’t a soft metric. It’s an operational lever.

And clarity doesn’t require a new EHR or AI overhaul. It starts with rethinking how instructions are organized, when they’re delivered, and how well they match the patient’s real-world experience.

Good Design Is Good Business
If your instructions read like a liability waiver, patients will treat them like one.

But when instructions are designed for clarity—timed to the patient’s journey and written with their perspective in mind—adherence improves, complications drop, and staff are freed up to do the work that actually requires a human touch.

In a field where margins are tight and burnout is high, investing in clarity isn’t just a better experience. It’s better business.

Sources
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1. Müller R, et al. “Outpatients’ perception of their preoperative information… processes.” Medicine (Baltimore). 2021.
2. Kutner M, Greenberg E, Jin Y, Paulsen C. The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy. U.S. Department of Education, National Center for Education Statistics.
3. CMS. Overall Hospital Quality Star Rating: Methodology Report. Centers for Medicare & Medicaid Services.