Discharge summaries (DS) play a large role in transition of care from the inpatient to outpatient setting. At academic centers DS are largely completed by house staff, though few residency programs and medical schools have dedicated education on DS and their role in transitions of care. At our institution discharge summary quality is variable, no uniform template exists, and outpatient providers voice dissatisfaction with the DS. Based on a few reports in the literature of successful educational interventions, we hypothesized that implementation of an educational session on key components of DS, their role in transitions of care, and use of a discharge summary template would result in improved variability of DS and outpatient primary care provider (PCP) satisfaction with DS.
We performed a needs assessment survey to determine outpatient PCP satisfaction with DS and to identify components of the discharge summary most important to outpatient PCPs. Key components of the discharge summary were determined based on recommendations from JACHO, The Transitions of Care Consensus Conference, Society of Hospital Medicine, and results from our needs assessment survey. We implemented a one hour education session during morning report at our hospital focusing on key components of DS, role of DS in transition of care from inpatient to outpatient setting, and use of a discharge template. The session was a mix of lecture and small group activity. Surveys of outpatient PCPs to assess discharge summary variability and satisfaction were distributed pre and post intervention.
Results from the pre-intervention needs assessment survey showed that 55% of outpatient providers were satisfied with discharge summaries, 32.5% were dissatisfied, and 12.5% were very satisfied. The majority of outpatient providers surveyed reported variability in discharge summaries with 27.5% extremely variable, 37.5% generally variable, 30% generally consistent and 5% extremely consistent. Responses from the post intervention survey showed 78.3% of PCPs were satisfied, 4.3% were dissatisfied, and 17.4% were very satisfied with DS. Similarly post intervention 4.3% of discharge summaries were extremely variable, 30.4% generally variable and 65.2% generally consistent.
A one hour education session with house staff and implementation of a discharge summary template can improve outpatient PCP satisfaction with DS and improve variability of DS. Future directions include scoring the quality of the pre and post DS using a rubric based on review of the literature and improving communication between inpatient and outpatient providers during the discharge process to further improve transition of care.
To cite this abstract:Munchhof, A . EDUCATION OF RESIDENTS TO IMPROVE DISCHARGE SUMMARY VARIABILITY AND OUTPATIENT PRIMARY CARE PROVIDER SATISFACTION. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 260. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/education-of-residents-to-improve-discharge-summary-variability-and-outpatient-primary-care-provider-satisfaction/. Accessed September 17, 2019.