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Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

BACKGROUND: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. OBJECTIVE: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpat...

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Autores principales: Gilliam, Meredith, Krein, Sarah L, Belanger, Karen, Fowler, Karen E, Dimcheff, Derek E, Solomon, Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406115/
https://www.ncbi.nlm.nih.gov/pubmed/28491308
http://dx.doi.org/10.1177/2050312117701053
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author Gilliam, Meredith
Krein, Sarah L
Belanger, Karen
Fowler, Karen E
Dimcheff, Derek E
Solomon, Gabriel
author_facet Gilliam, Meredith
Krein, Sarah L
Belanger, Karen
Fowler, Karen E
Dimcheff, Derek E
Solomon, Gabriel
author_sort Gilliam, Meredith
collection PubMed
description BACKGROUND: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. OBJECTIVE: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. METHODS: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. RESULTS: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04), and to 2.8 h in 2015 (p < 0.001). CONCLUSION: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process.
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spelling pubmed-54061152017-05-10 Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction Gilliam, Meredith Krein, Sarah L Belanger, Karen Fowler, Karen E Dimcheff, Derek E Solomon, Gabriel SAGE Open Med Original Article BACKGROUND: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. OBJECTIVE: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. METHODS: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. RESULTS: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04), and to 2.8 h in 2015 (p < 0.001). CONCLUSION: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process. SAGE Publications 2017-03-29 /pmc/articles/PMC5406115/ /pubmed/28491308 http://dx.doi.org/10.1177/2050312117701053 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Gilliam, Meredith
Krein, Sarah L
Belanger, Karen
Fowler, Karen E
Dimcheff, Derek E
Solomon, Gabriel
Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title_full Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title_fullStr Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title_full_unstemmed Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title_short Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
title_sort novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406115/
https://www.ncbi.nlm.nih.gov/pubmed/28491308
http://dx.doi.org/10.1177/2050312117701053
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