WHEN ARE WE TOO BUSY TO SUMMARIZE? ASSOCIATION OF PRACTICE CHARACTERISTICS WITH HOSPITALISTS’ PERCEIVED BURDEN OF PREPARING HOSPITAL DISCHARGE SUMMARIES

Nian-En Chiang, MD*;Atsushi Sorita, MD, MPH;Sarah M. Jenkins and Deanne T. Kashiwagi, MD, Mayo Clinic, Rochester, MN

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

Abstract number: 245

Categories: Research Abstracts, Transitions of Care

Keywords: , ,

Background: Patients admitted to inpatient hospital services are increasingly cared for by hospitalists rather than their primary care providers. When transitioning from hospital-based to ambulatory care, suboptimal information transfer can lead to serious adverse events and readmissions; therefore, demands for timely preparation of high-quality discharge summaries are increasing. Confronted with these demands, most hospitalists are confident in writing a high-quality discharge summary, but many also agree that they feel too busy to do so. The aim of our analysis is to identify practice characteristics that may associate with hospitalists’ perceived burden of generating high-quality discharge summaries.Methods: Using the Society of Hospital Medicine’s mailing list, we surveyed a random sample of 800 internal medicine hospitalists in the United States in 2015 regarding hospital discharge summaries. Among the surveyed questions, this study focused on average agreement to feeling “too busy to prepare a high-quality discharge summary” (5-point Likert agreement scale) as the dependent variable. Independent variables were hospitalist practice characteristics including completion of discharge summary upon discharge, whether summaries were given to patients at time of discharge, years in practice, and practice community size. The average agreement was compared across hospitalist characteristics with linear regression to evaluate for significant associations.

Results: A total of 341 hospitalists responded to our survey (43% response rate). We found that hospitalists who completed their discharge summaries 48 hours or later after discharge were more likely to feel too busy to prepare high-quality summaries as compared to those who completed them upon discharge (54% vs 40% somewhat/strongly agree; average agreement 3.30 vs 2.77, p=0.002). Furthermore, hospitalists with fewer years of practice were more likely to report feeling too busy (51% vs 43% vs 28% somewhat/strongly agree; average agreement 3.14 vs 2.88 vs 2.42 for ≤10, 11-20, and ≥21 years, respectively, p=0.001). These findings remained significant when adjusted for each other, in addition to adjusting for practice community size and whether summaries were given to patients at time of discharge.

Conclusions: Completion of discharge summaries 48 hours or later after discharge and practice experience of fewer than 10 years were associated with hospitalists’ feeling too busy to prepare high-quality discharge summaries. On the other hand, practice community size and whether summaries were given directly to the patients upon discharge did not have significant associations with this feeling. An additional subanalysis of practice experience and perceived adequacy of training in preparing discharge summaries may identify potential areas of improvement in hospitalist training.

To cite this abstract:

Chiang, NE; Sorita, A; Jenkins, SM; Kashiwagi, DT . WHEN ARE WE TOO BUSY TO SUMMARIZE? ASSOCIATION OF PRACTICE CHARACTERISTICS WITH HOSPITALISTS’ PERCEIVED BURDEN OF PREPARING HOSPITAL DISCHARGE SUMMARIES. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 245. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/when-are-we-too-busy-to-summarize-association-of-practice-characteristics-with-hospitalists-perceived-burden-of-preparing-hospital-discharge-summaries/. Accessed September 20, 2019.

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