Communication is central to the coordination of quality patient care. Yet studies have documented poor communication among physicians and have associated poor communication with serious adverse outcomes. A recent meta‐analysis revealed that direct communication between hospitals and primary care physicians (PCPs) occurs infrequently (3%‐20%). The availability of a discharge summary at the first postdischarge visit is low (12%‐34%). Furthermore, even when available, discharge summaries often lack important information including test results (33%‐63%), treatment or hospital course (7%‐22%), discharge medications (2%‐40%), test results pending at discharge (65%), and follow‐up plans (2%‐43%).
Our goal was to design and implement a system to optimize communication between our hospitalist service and the primary care physicians and patients it serves.
We identified that at every critical juncture (admission to the hospital, critical events during the hospitalization and at the time of hospital discharge), 2‐way communication needed to occur between the hospitalist and the primary care physician. We utilized the Royal College of Physicians Informatics Unit's “Draft Standards” to identify critical elements that should be included. In the absence of a “real‐time” electronic medical record, we developed an Access®‐database designed explicitly to feed the communication documents to be faxed to the PCPs' offices. Clerical staff were trained to abstract the chart, perform data entry, print and dispatch our documents after hospitalist validation within 24 hours of admission, discharge, or critical event. Each document invites the PCP to dialogue with the hospitalist through direct dial. The clinical coordinators also provide a copy of the discharge document to the patient.
The traditional methods of completing and delivering admission and discharge communication are suboptimal for timely communication between hospitals and PCPs. The use of a purposefully designed database, clinical coordinators and hospitalist‐validated communication documents ensures efficient, timely, accurate, and relevant communication to the PCP. Future research will assess the impact of this system on patient and physician satisfaction and ultimately on patient outcomes.
S. Smith, McLaren Regional Medical Center, Employment; H. Sohail, McLaren Regional Medical Center, employment.
To cite this abstract:Smith S, Sohail H. A Novel System Designed to Optimize Communication between Hospitalists and Primary Care Physicians. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 121. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/a-novel-system-designed-to-optimize-communication-between-hospitalists-and-primary-care-physicians/. Accessed March 20, 2019.