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

Gregory A. Harlan, Flory L. Nkoy, Rajendu Srivastava, Gena Lattin, Doug Wolfe, Michael B. Mundorff, Dayvalena Colling, Angelika Valdez, Shay Lange, Sterling D. Atkinson, Lawrence J. Cook, Christopher G. Maloney

Research output: Contribution to journalArticle

22 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)51-60
Number of pages10
JournalJournal for healthcare quality : official publication of the National Association for Healthcare Quality
Volume32
Issue number5
DOIs
Publication statusPublished - Jan 1 2010

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ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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