A Brief Structured Peertopeer Feedback Intervention to Improve the Quality of Resident Discharge Summaries

1University of California, San Francisco, San Francisco, CA
2San Francisco General Hospital, San Francisco, CA

Meeting: Hospital Medicine 2012, April 1-4, San Diego, Calif.

Abstract number: 97695

Background:

High–quality communication is required for safe hospital discharge and is accomplished primarily through the discharge summary. Clear, concise, and meaningful correspondence between providers is essential and yet, first year medical residents are generally charged with completing discharge summaries with little or no training. While prior studies have described didactic curricula with direct feedback, we are not aware of any curricula that take advantage of peer–to–peer feedback.

Purpose:

We ventured to strengthen the quality of discharge summary training for interns rotating through the department of medicine at our institution by incorporating an element of structured peer–to–peer feedback regarding the content, readability, efficiency, and comprehensiveness of their own discharge summaries.

Description:

Based on literature review and an internal needs assessment of problems with discharge summaries, we developed an educational curriculum consisting of (1) a didactic session illustrating quality gaps in discharge summaries at our institution and best practices for improvement, followed by (2) a 1–hour session dedicated to directed peer–to–peer feedback for interns to evaluate their own summaries. An evaluation tool, focusing on five elements of the discharge summary was developed to facilitate peer assessment. During the peer–to–peer feedback session, interns completed a brief pre–test regarding their confidence with discharge summaries. They exchanged their own discharge summary with a partner and evaluated it with the standardized rubric. The larger group congregated and summarized the strengths and weaknesses of their own discharge summaries and focused on areas for future improvement. Finally, participants completed a brief post–test assessment of their experience with the session. In total, 58 learners participated in this curriculum and completed evaluation. 29 (50%) were medical interns, 13 (22%) were prelim interns from other departments and 16 (28%) were students. While only 22% of respondents were satisfied with the quality of their discharge summary, 98% of residents agreed that it is useful to develop and improve skills in writing D/C summaries. 81% of residents thought the peer–to–peer feedback session was comfortable, and 85% thought that it was helpful.

Conclusions:

We developed a unique educational innovation involving a peer–to–peer feedback session for PGY1 residents to assess the quality of their own discharge summaries. The peer–to–peer evaluation was a powerful tool for allowing interns to identify their own strengths and weaknesses in writing concise and accurate discharge summaries, and was a high yield mechanism for promoting learning and retention compared to traditional didactic sessions. This peer–to–peer feedback session could easily be repeated in most academic clinical settings to improve the quality of discharge summaries written by residents.

To cite this abstract:

Soni K, Lozada M, Schneidermann M. A Brief Structured Peertopeer Feedback Intervention to Improve the Quality of Resident Discharge Summaries. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97695. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/a-brief-structured-peertopeer-feedback-intervention-to-improve-the-quality-of-resident-discharge-summaries/. Accessed September 18, 2019.

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