Discharge (DC) communication processes should be driven by the preferences of primary care providers (PCP) who follow‐up patients post‐discharge. Despite the growth of hospital‐affiliated primary care networks, many practices remain independent. Network affiliation provides enhanced post‐DC information access; therefore, based on network status, DC communication preferences of PCPs may differ. The discharging provider must adapt to the diverse communication preferences of many unique outpatient providers. The objectives of this study were to understand the preferences of in‐network and out‐of‐network PCPs regarding methods and timeliness of DC communication and to understand PCP level of satisfaction with current DC communication processes.
We developed a 12‐item survey and distributed it to a convenience sample of local PCPs from 10/2012 to 3/2013. PCPs completed surveys electronically or manually; survey items were identical regardless of method. A similar survey was electronically distributed to hospitalists at Duke University Medical Center (DUMC) and its community affiliate, Durham Regional Hospital (DRH). Survey responses were compared between PCPs in the Duke University Health System network versus out‐of‐network. Likewise, survey responses were compared between PCPs and hospitalists. Likert scale responses were reported as means and compared using Wilcoxon Rank‐Sum tests. Binary responses were compared using Fisher’s exact tests.
Of 89 PCPs surveyed, 59 responded (66%); 31 respondents were in‐network (53%) and 28 were out‐of‐network (47%). Of 58 hospitalists surveyed, 36 responded (62%). In‐network PCPs preferred electronic DC communication methods (EHR: 65% vs 32%, p=0.02; email: 45% vs 14%, p<0.001), while out‐of‐network PCPs preferred paper‐based methods (fax: 75% vs 10%; p<0.001). Regardless of network status, PCPs preferred to receive communication from inpatient providers upon admission and at discharge. Out‐of‐network PCPs were less satisfied with the timeliness of DC communication (Table 1). PCPs preferred hospitalists to take responsibility for follow‐up and communication of pending lab test results to patients post‐discharge (58% vs 14%, p<0.001), while hospitalists preferred this to be a shared responsibility between inpatient and outpatient providers (72% vs 36%, p<0.001).
PCPs in‐ and out‐of‐network differed in their DC communication preferences and level of satisfaction. PCPs and hospitalists differed in regards to the communication of test results pending at the time of DC. Implementation of more inclusive DC communication strategies and standardization of pending result communication may improve the quality of DC communication and provider satisfaction with the DC process.
To cite this abstract:Ming D, Stephany A, Powers B. Variation in Discharge Communication Preferences of Primary Care Providers and Hospitalists in a Hospital‐Affiliated Health Network. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 12. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/variation-in-discharge-communication-preferences-of-primary-care-providers-and-hospitalists-in-a-hospitalaffiliated-health-network/. Accessed April 25, 2019.