TRANSITIONS OF CARE: ASSESSING SATISFACTION OF DISCHARGE COMMUNICATION BETWEEN INPATIENT AND OUTPATIENT PROVIDERS

Melissa M MacDonald, MD*1;Eric Nolan, MD2 and Jennifer Jeskey-Sabuda, MD1, (1)University of Wisconsin Hospital and Clinics, Madison, WI, (2)The Ohio State University, Columbus, OH

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 255

Categories: Research Abstracts, Transitions of Care

Background: Poor communication between healthcare providers has been identified as an important contributor to poor patient outcomes and adverse events. The transition period from inpatient to outpatient care is a particularly high risk time for patients in which they are vulnerable to adverse events. Enhanced communication between inpatient and outpatient providers may improve outcomes during this period.

Methods:

We surveyed inpatient and outpatient providers at our health system in the departments of pediatrics, internal medicine and family medicine regarding their opinions on current discharge communication and preferred modes of communication in various patient situations. Two electronic surveys were developed in order to do this. One survey was sent to the pediatric and adult hospitalists at our institution and the other was sent to primary care providers at affiliated clinics.

Results:

Surveys were completed by 25 inpatient providers and 65 primary care providers within our health system.  Of outpatient providers surveyed, a majority (52%) were satisfied with current communication at discharge and a minority (13%) were dissatisfied. The most commonly cited barrier to communication was lack of time (68% of outpatient and 52% of inpatient providers). For most specific patient situations given on the survey, a majority of inpatient and outpatient providers preferred electronic communication (secure messaging or in-basket messages via the electronic medical record) in situations where communication beyond the discharge summary was warranted. Situations in which outpatient providers preferred verbal communication included patients with an unexpected major change in treatment plan, patients transitioning to comfort care or who had died, and patients who would require follow-up shortly after discharge. Often, the majority of inpatient and outpatient providers agreed on methods of communication for specific situations.

Conclusions:

Though a majority of outpatient providers within our health system are satisfied with communication at discharge, the fact that 48% of providers are neutral or dissatisfied suggests there is room for improvement. With the importance of transition from inpatient to outpatient care for adverse events for patients it is important to identify specific ways to optimize communication. There was a clear indication that for most specific situations listed, electronic communication was an effective and preferred way to add to information communicated with the discharge summary. However, a majority of outpatient providers preferred verbal communication for certain high complexity situations. We hope this information may guide practice on communication in order to decrease adverse events following discharge, while also keeping in mind the barrier of time constraints endorsed by most providers.

To cite this abstract:

MacDonald, MM; Nolan, E; Jeskey-Sabuda, J . TRANSITIONS OF CARE: ASSESSING SATISFACTION OF DISCHARGE COMMUNICATION BETWEEN INPATIENT AND OUTPATIENT PROVIDERS. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 255. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/transitions-of-care-assessing-satisfaction-of-discharge-communication-between-inpatient-and-outpatient-providers/. Accessed September 20, 2019.

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