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Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Design of an orthopaedic-specific discharge summary

Authors: Christine Soong, Bochra Kurabi, Kathleen Exconde, Faiqa Tajammal, Chaim M. Bell

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

Patients undergoing orthopaedic procedures experience major changes in function and daily routines upon their return home. Discharge summaries are an important communication tool that may play a role in optimizing a safe transition from hospital. Current care gaps and key elements of an ideal discharge summary specific for orthopaedic population are unknown. We sought to identify the challenges of current orthopaedic discharge summaries and to determine key elements of an ideal document.

Methods

Qualitative study survey using semi-structured interviews with a sample of 17 patients and clinicians representing diverse professions, backgrounds, and practice settings. We used the constant comparative method of qualitative analysis to define the experiences and perceptions of quality gaps and strategies to improve orthopaedic-specific discharge summaries.

Results

We identified 3 major themes describing factors perceived to be limiting the quality of current discharge summaries: 1) physician-centric documentation and the absence of a comprehensive, inter-professional perspective; 2) access to resources and health informatics; and 3) process variations in document creation and dissemination.

Conclusions

Clinicians and patients identified several factors limiting the quality of discharge summaries among orthopaedic inpatients. Incorporating these elements could improve hospital transitions.
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Literature
1.
go back to reference Chandra A, Dalton MA, Holmes J. Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings. Health Aff (Millwood). 2013;32:864–72.CrossRef Chandra A, Dalton MA, Holmes J. Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings. Health Aff (Millwood). 2013;32:864–72.CrossRef
2.
go back to reference Forster AJ, et al. Adverse events among medical patients after discharge from hospital. Can J Med Association. 2004;170:345–9. Forster AJ, et al. Adverse events among medical patients after discharge from hospital. Can J Med Association. 2004;170:345–9.
3.
go back to reference Were MC, et al. Adequacy of Hospital Discharge Summaries in Documenting Tests with Pending Results and Outpatient Follow-up Providers. J Gen Intern Med. 2009;24:1002–6.CrossRefPubMedPubMedCentral Were MC, et al. Adequacy of Hospital Discharge Summaries in Documenting Tests with Pending Results and Outpatient Follow-up Providers. J Gen Intern Med. 2009;24:1002–6.CrossRefPubMedPubMedCentral
4.
go back to reference Auerbach AD, et al. Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients. JAMA Intern Med. 2016;176:484–93.CrossRefPubMed Auerbach AD, et al. Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients. JAMA Intern Med. 2016;176:484–93.CrossRefPubMed
5.
go back to reference Li JYZ, Yong TY, Hakendorf P, Ben-Tovim D, Thompson CH. Timeliness in discharge summary dissemination is associated with patients' clinical outcomes. J Eval Clin Pract. 2011;19:76–9.CrossRefPubMed Li JYZ, Yong TY, Hakendorf P, Ben-Tovim D, Thompson CH. Timeliness in discharge summary dissemination is associated with patients' clinical outcomes. J Eval Clin Pract. 2011;19:76–9.CrossRefPubMed
6.
go back to reference Kind AJH, Thorpe CT, Sattin JA, Walz SE, Smith MA. Provider characteristics, clinical-work processes and their relationship to discharge summary quality for sub-acute care patients. J Gen Intern Med. 2012;27:78–84.CrossRefPubMed Kind AJH, Thorpe CT, Sattin JA, Walz SE, Smith MA. Provider characteristics, clinical-work processes and their relationship to discharge summary quality for sub-acute care patients. J Gen Intern Med. 2012;27:78–84.CrossRefPubMed
7.
go back to reference Henriksen, K. et al. Documentation of Mandated Discharge Summary Components in Transitions from Acute to Subacute Care. (Agency for Healthcare Research and Quality (US), 2008). Henriksen, K. et al. Documentation of Mandated Discharge Summary Components in Transitions from Acute to Subacute Care. (Agency for Healthcare Research and Quality (US), 2008).
8.
go back to reference Patton, M. Q. Qualitative evaluation and research methods. 2000 Patton, M. Q. Qualitative evaluation and research methods. 2000
9.
go back to reference Kripalani S, et al. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297:831–41.CrossRefPubMed Kripalani S, et al. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297:831–41.CrossRefPubMed
10.
go back to reference Kattel, S. et al. Information Transfer at Hospital Discharge: A Systematic Review. J Patient Saf. 2016;1:1–9. Kattel, S. et al. Information Transfer at Hospital Discharge: A Systematic Review. J Patient Saf. 2016;1:1–9.
12.
13.
14.
15.
go back to reference Reinke CE, et al. Timeliness and quality of surgical discharge summaries after the implementation of an electronic format. Am J Surg. 2014;207:7–16.CrossRefPubMed Reinke CE, et al. Timeliness and quality of surgical discharge summaries after the implementation of an electronic format. Am J Surg. 2014;207:7–16.CrossRefPubMed
16.
go back to reference Halasyamani L, et al. Transition of care for hospitalized elderly patients—Development of a discharge checklist for hospitalists. J Hosp Med. 2006;1:354–60.CrossRefPubMed Halasyamani L, et al. Transition of care for hospitalized elderly patients—Development of a discharge checklist for hospitalists. J Hosp Med. 2006;1:354–60.CrossRefPubMed
17.
go back to reference Mohta N, et al. The effects of a ‘discharge time-out’ on the quality of hospital discharge summaries. BMJ Qual Saf. 2012;21:885–90.CrossRefPubMed Mohta N, et al. The effects of a ‘discharge time-out’ on the quality of hospital discharge summaries. BMJ Qual Saf. 2012;21:885–90.CrossRefPubMed
18.
go back to reference Joint Commission on Accreditation of Healthcare Organizations. Hospital Accreditation Standards. 2008. Joint Commission on Accreditation of Healthcare Organizations. Hospital Accreditation Standards. 2008.
19.
go back to reference Uppal NK, et al. Transfer of care of postsurgical patients from hospital to the community setting: cross-sectional survey of primary care physicians. Am J Surg. 2015;210:778–82.CrossRefPubMed Uppal NK, et al. Transfer of care of postsurgical patients from hospital to the community setting: cross-sectional survey of primary care physicians. Am J Surg. 2015;210:778–82.CrossRefPubMed
20.
go back to reference Harel Z, Wald R, Perl J, Schwartz D, Bell CM. Evaluation of deficiencies in current discharge summaries for dialysis patients in Canada. JMDH. 2012;5:77–84.CrossRefPubMedPubMedCentral Harel Z, Wald R, Perl J, Schwartz D, Bell CM. Evaluation of deficiencies in current discharge summaries for dialysis patients in Canada. JMDH. 2012;5:77–84.CrossRefPubMedPubMedCentral
Metadata
Title
Design of an orthopaedic-specific discharge summary
Authors
Christine Soong
Bochra Kurabi
Kathleen Exconde
Faiqa Tajammal
Chaim M. Bell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1783-x

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