Continuity of Patient Care, Hospital Information Systems, Medical Records Systems, Computerized, Patient Discharge
Conditions
Keywords
Hospitalization, Continuity of care, Discharge summary, Quality improvement, Medical records systems, Hospital information systems
Brief summary
The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.
Detailed description
For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care. Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community. We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.
Interventions
OTHERElectronic discharge summary system
The customized electronic discharge summary program will be used to generate patient discharge summaries.
Sponsors
Unity Health Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Hospitalization on General Internal Medicine ward at St. Michael's Hospital
Exclusion criteria
* Transfer to another service * Death during admission * Remains in hospital past dates specified in study protocol
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale | Satisfaction score assessment form to be sent one week after patient's discharge from hospital. If form is not returned in 14 days, a reminder and second form will be sent. |
Secondary
| Measure | Time frame |
|---|---|
| Completion of specialist outpatient workups at St. Michael's Hospital recommended during course of hospitalization | Within the first 30 days of patient's discharge from hospital |
| Patient visits to Emergency Room at St. Michael's Hospital | Within the first 30 days after patient's discharge from hospital |
| St. Michael's Hospital housestaff satisfaction from satisfaction score assessment form with 100-mm visual analogue scale | Housestaff will fill out form upon completion of the rotation during which the study has been performed |
| Prescribing errors as assessed by comparing discharge summary to inpatient record | Upon discharge |
| Patient readmissions to St. Michael's Hospital | Within 30 days of discharge |
| Patient/proxy care transition assessment through the use of the CTM-3. | Phone call made to patient or proxy one week after discharge. If patient/proxy is not reached, follow up calls will be made daily until patient/proxy is reached. |
Countries
Canada
Outcome results
None listed