Purpose: To evaluate the adult patient's understanding of the emergency department (ED) discharge instructions and motivation to use an online health education website. A survey of the ED staff was incorporated into the study to evaluate the ED staff members' motivation to include patient education on an online health education website prior to discharge. Background & Significance: There are six major knowledge gaps in the ED discharge process: (a) education, (b) care management, (c) follow-up and discharge, (d) communication, (e) health care provider accountability and (f) health literacy (Shepard, Donovan, & Lyons, 2010). Patient-centered transition and discharge management that focuses on these knowledge gaps will promote satisfactory health outcomes. The Health Belief Model theorizes that a sustained change in behavior is influenced by internal motivation and perception of the illness. Cognitive knowledge and ED staff motivation to educate the patients on the use of an online health education website will improve health literacy. Methods: This was a descriptive cross-sectional quantitative study, conducted from March-June, 2012, in a 52-bed ED facility in an urban setting. A simple unbiased random sample of adult patients (n = 100) was surveyed in the ED prior to discharge. Inclusion criteria included alert adult patients and confused patients with a family member at the bedside. Exclusion criteria included pediatric patients and confused patients without a family member at the bedside. Family members assisted the primary investigator with interpretation of the survey questions for non-English speaking patients. ED staff (n = 45) was surveyed in October, 2012. This was a single-center study, not all potentially eligible patients or staff could be surveyed, and the outcome assessment relied on the participants' answers to the surveys. Results: The majority of participants did not understand the discharge instructions. The Pearson chi-square was statistically significant and indicated a "reasonable difference" between the preferred method of learning and understanding of the discharge instructions. Cramer's V indicated a "reasonable association" between the preferred method of learning and understanding the discharge instructions. Motivation to use an online health education website indicated a central tendency mean of 3.02, (0 is not motivated and 5 is very motivated). There was a relationship between motivation and the use of the online website. A survey completed by 45 ED staff members indicated that 76.1% of the ED staff were motivated to provide information about the online health education website to the patient prior to discharge. Conclusions and Clinical Implications: The data suggest that the majority of patients are being discharged without a thorough understanding of the treatment plan. There is a statistically "reasonable difference" and "association" between the preferred method of learning and understanding. The data suggest more time and effort are needed for effective communication. Information available through a health education website, such as kp.org, "My Health Manager", that provides a visual or audio learning method may provide a better understanding of the medical condition, encourage critical decision making, and improve adherence to the treatment plan. The Health Belief Model theorized by Nola Pender (Pender, Murdaugh & Parsons, 2010) asserts that a sustained change in behavior is achieved more effectively when the motivation to do so is elicited internally by the patient rather than imposed by others. A patient-centered technique, such as collaborative goal setting, which aims to promote internal motivation, has been associated with improved health outcomes (Picker Institute, 2012). Ultimately, these efforts would address the major knowledge gaps in the ED process and may reduce ED revisits, [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]