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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Main Authors:	Meredith Gilliam, Sarah L Krein, Karen Belanger, Karen E Fowler, Derek E Dimcheff, Gabriel Solomon
Format:	Article
Language:	English
Published:	SAGE Publishing 2017-03-01
Series:	SAGE Open Medicine
Online Access:	https://doi.org/10.1177/2050312117701053

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spelling	doaj-3fa47539836f41cda252b54a84b16ab62020-11-25T02:47:50ZengSAGE PublishingSAGE Open Medicine2050-31212017-03-01510.1177/205031211770105310.1177_2050312117701053Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfactionMeredith Gilliam0Sarah L Krein1Karen Belanger2Karen E Fowler3Derek E Dimcheff4Gabriel Solomon5Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USADepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USAVA Ann Arbor Healthcare System, Ann Arbor, MI, USAVA Ann Arbor Healthcare System, Ann Arbor, MI, USADepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USADepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USABackground: 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.https://doi.org/10.1177/2050312117701053
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Meredith Gilliam Sarah L Krein Karen Belanger Karen E Fowler Derek E Dimcheff Gabriel Solomon
spellingShingle	Meredith Gilliam Sarah L Krein Karen Belanger Karen E Fowler Derek E Dimcheff Gabriel Solomon Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction SAGE Open Medicine
author_facet	Meredith Gilliam Sarah L Krein Karen Belanger Karen E Fowler Derek E Dimcheff Gabriel Solomon
author_sort	Meredith Gilliam
title	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_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_sort	novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction
publisher	SAGE Publishing
series	SAGE Open Medicine
issn	2050-3121
publishDate	2017-03-01
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.
url	https://doi.org/10.1177/2050312117701053
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Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

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