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Improving transitions of care at hospital discharge--implications for pediatric hospitalists and primary care providers.

Abstract

Delays, omissions, and inaccuracy of discharge information are common at hospital discharge and put patients at risk for adverse outcomes. We assembled an interdisciplinary team of stakeholders to evaluate our current discharge process between hospitalists and primary care providers (PCPs). We used a fishbone diagram to identify potential causes of suboptimal discharge communication to PCPs. Opportunities for improvement (leverage points) to achieve optimal transfer of discharge information were identified using tally sheets and Pareto charts. Quality improvement strategies consisted of training and implementation of a new discharge process including: (1) enhanced PCP identification at discharge, (2) use of an electronic discharge order and instruction system, and (3) autofaxing discharge information to PCPs. The new discharge process's impact was evaluated on 2,530 hospitalist patient discharges over a 34-week period by measuring: (1) successful transfer of discharge information (proportion of discharge information sheets successfully faxed to PCPs), (2) timeliness (proportion of sheets faxed within 2 days of discharge), and (3) content (presence of key clinical elements in discharge sheets). Postintervention, success, and timeliness of discharge information transfer between pediatric hospitalists and PCPs significantly improved while content remained high.

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  • Authors+Show Affiliations

    ,

    Medical Affairs, IPC-The Hospitalist Company, North Hollywood, CA, USA.

    , , , , , , , , , ,

    Source

    MeSH

    Child
    Continuity of Patient Care
    Hospitalists
    Hospitals, Pediatric
    Humans
    Interprofessional Relations
    Patient Discharge
    Primary Health Care
    Prospective Studies
    Utah

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20854359

    Citation

    Harlan, Gregory A., et al. "Improving Transitions of Care at Hospital Discharge--implications for Pediatric Hospitalists and Primary Care Providers." Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality, vol. 32, no. 5, 2010, pp. 51-60.
    Harlan GA, Nkoy FL, Srivastava R, et al. Improving transitions of care at hospital discharge--implications for pediatric hospitalists and primary care providers. J Healthc Qual. 2010;32(5):51-60.
    Harlan, G. A., Nkoy, F. L., Srivastava, R., Lattin, G., Wolfe, D., Mundorff, M. B., ... Maloney, C. G. (2010). Improving transitions of care at hospital discharge--implications for pediatric hospitalists and primary care providers. Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality, 32(5), pp. 51-60. doi:10.1111/j.1945-1474.2010.00105.x.
    Harlan GA, et al. Improving Transitions of Care at Hospital Discharge--implications for Pediatric Hospitalists and Primary Care Providers. J Healthc Qual. 2010;32(5):51-60. PubMed PMID: 20854359.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Improving transitions of care at hospital discharge--implications for pediatric hospitalists and primary care providers. AU - Harlan,Gregory A, AU - Nkoy,Flory L, AU - Srivastava,Rajendu, AU - Lattin,Gena, AU - Wolfe,Doug, AU - Mundorff,Michael B, AU - Colling,Dayvalena, AU - Valdez,Angelika, AU - Lange,Shay, AU - Atkinson,Sterling D, AU - Cook,Lawrence J, AU - Maloney,Christopher G, Y1 - 2010/07/23/ PY - 2010/9/22/entrez PY - 2010/9/22/pubmed PY - 2010/12/14/medline SP - 51 EP - 60 JF - Journal for healthcare quality : official publication of the National Association for Healthcare Quality JO - J Healthc Qual VL - 32 IS - 5 N2 - Delays, omissions, and inaccuracy of discharge information are common at hospital discharge and put patients at risk for adverse outcomes. We assembled an interdisciplinary team of stakeholders to evaluate our current discharge process between hospitalists and primary care providers (PCPs). We used a fishbone diagram to identify potential causes of suboptimal discharge communication to PCPs. Opportunities for improvement (leverage points) to achieve optimal transfer of discharge information were identified using tally sheets and Pareto charts. Quality improvement strategies consisted of training and implementation of a new discharge process including: (1) enhanced PCP identification at discharge, (2) use of an electronic discharge order and instruction system, and (3) autofaxing discharge information to PCPs. The new discharge process's impact was evaluated on 2,530 hospitalist patient discharges over a 34-week period by measuring: (1) successful transfer of discharge information (proportion of discharge information sheets successfully faxed to PCPs), (2) timeliness (proportion of sheets faxed within 2 days of discharge), and (3) content (presence of key clinical elements in discharge sheets). Postintervention, success, and timeliness of discharge information transfer between pediatric hospitalists and PCPs significantly improved while content remained high. SN - 1062-2551 UR - https://www.unboundmedicine.com/medline/citation/20854359/Improving_transitions_of_care_at_hospital_discharge__implications_for_pediatric_hospitalists_and_primary_care_providers_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1062-2551&date=2010&volume=32&issue=5&spage=51 DB - PRIME DP - Unbound Medicine ER -