scholarly journals Latent topic discovery of clinical concepts from hospital discharge summaries of a heterogeneous patient cohort

2014 ◽  
Author(s):  
Li-wei Lehman ◽  
William Long ◽  
Mohammed Saeed ◽  
Roger Mark
Keyword(s):  
Hospital Discharge ◽  
Patient Cohort ◽  
Topic Discovery ◽  
Latent Topic ◽  
Discharge Summaries

Independent Prescribing Pharmacists Supporting the Early Discharge of Patients Through Completion of Medical Discharge Summaries

2018 ◽  
Vol 33 (2) ◽  
pp. 173-175 ◽  
Author(s):  
Martin J. Biggs ◽  
Timothy C. Biggs
Keyword(s):  
Hospital Discharge ◽  
Medication Errors ◽  
Early Discharge ◽  
Discharge Summary ◽  
Medical Decision ◽  
Junior Doctors ◽  
Allied Health Professionals ◽  
Independent Prescribing ◽  
Discharge Summaries ◽  
Improve Service Delivery

Purpose: Independent prescribing pharmacists are able to independently prescribe medications following additional postgraduate training. This study examined their use in completing medical discharge summaries, normally completed by junior doctors, in order to assess their impact on expedited hospital discharge times. Methods: In total, 163 patients were studied through a 2-stage audit. The first cycle evaluated junior doctors completing medical discharge summaries (as is normal practice). Three independent prescribing pharmacists were then trained to complete discharge summaries, and a second cycle was completed. Results: Following implementation of independent prescribing pharmacists to complete medical discharge summaries, the time from medical decision to discharge to summary completion dropped significantly (mean of 2:42 hours to 1:35 hours, P < .001). The time from medical decision to discharge to actual hospital discharge also dropped significantly (mean of 5:21 hours to 3:58 hours, P < .01). The number of discharge summary medication errors dropped significantly ( P < .05) between audit cycles. Conclusion: The introduction of independent prescribing pharmacists to complete medical discharge summaries has significantly reduced the time to summary completion, discharge time, and the number of medication errors. In a time of limited medical resources and bed shortages, the use of allied health professionals to improve service delivery is of paramount importance. This project is the first of its kind within the literature.

scholarly journals Cancer Survivorship Care Plans: What Can Be Learned From Hospital Discharge Summaries?

2012 ◽  
Vol 8 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Larissa Nekhlyudov ◽  
Jeffrey L. Schnipper
Keyword(s):  
Hospital Discharge ◽  
Cancer Survivorship ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Discharge Summaries

Exploration of potential lessons from hospital discharge summaries, which may be used to facilitate development, implementation, and testing of survivorship care plans.

scholarly journals Real-life implementation of guidelines on the hospital-to-home transition for older patients: a cohort study in general practice

2019 ◽  
Vol 49 (1) ◽  
pp. 46-51
Author(s):  
Aline Hurtaud ◽  
François Lallier ◽  
Matthieu Heidet ◽  
Charline Arnoult ◽  
Moustapha Dramé ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cohort Study ◽  
Hospital Discharge ◽  
Older Patients ◽  
Real Life ◽  
Discharge Summary ◽  
Life Assessment ◽  
Hospital To Home ◽  
Discharge Summaries

Abstract Background hospital discharge is a critical event for older patients. The French guidelines recommended the swift transmission of a discharge summary to the general practitioner (GP) and a primary care consultation within 7 days. The relevance and feasibility of these guidelines have not previously been assessed. Objective to perform a real-life assessment of compliance with French guidelines on the transmission of discharge summaries and post-discharge medical reviews and to examine these factors’ association with 30-day readmissions. Design a prospective multicentre cohort study. Setting primary care (general practice) in France. Subjects a sample of GPs and the same number of patients aged 75 or over having consulted within 30 days of hospital discharge. Methods the main endpoints were the proportion of discharge summaries available and the proportion of patients consulting their GP within 7 days. The 30-day readmission rate was also measured. Factors associated with these endpoints were assessed in univariate and multivariate analyses. Results seventy-one GPs (mean ± standard deviation age: 49 ± 11; males: 62%) and 71 patients (mean age: 84 ± 5; males: 52%; living at home: 94%; cognitive disorders: 22%) were included. Forty-six patients (65%, [95% confidence interval [CI]]: 53–76) consulted their GP within 7 days of hospital discharge. At the time of the consultation, 27 GPs (38% [95% CI]: 27–50) had not received the corresponding hospital discharge summary. Discharge summary availability was associated with a lower risk of 30-day readmission (adjusted odds ratio [95% CI] = 0.25 [0.07–0.91]). Conclusions compliance with the French guidelines on hospital-to-home transitions is insufficient.

scholarly journals A Structured Workshop to Improve the Quality of Resident Discharge Summaries

2012 ◽  
Vol 4 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Jaideep S. Talwalkar ◽  
Jason R. Ouellette ◽  
Shawnette Alston ◽  
Gregory K. Buller ◽  
Daniel Cottrell ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Discharge Summary ◽  
Faculty Members ◽  
Evaluation Tool ◽  
Outpatient Physician ◽  
Hospital Discharge Summary ◽  
Structured Program ◽  
Discharge Summaries

Abstract Background Poor communication at hospital discharge can increase the risk of adverse events. The hospital discharge summary is the most common tool for detailing events related to hospitalization in preparation for postdischarge follow-up, yet deficiencies in discharge summaries have been widely reported. Resident physicians are expected to dictate discharge summaries but receive little formal training in this arena. We hypothesized that implementation of an educational program on chart documentation skills would result in improvements in the quality of hospital discharge summaries in a community hospital internal medicine residency program. Methods A monthly, 1-hour workshop was launched in August 2007 to provide consistent and ongoing instruction on chart documentation. Guided by a faculty moderator, residents reviewed 2 randomly selected peer chart notes per session using instruments developed for that purpose. After the workshop had been in place for 2 years, 4 faculty members reviewed 63 randomly selected discharge summaries from spring 2007, spring 2008, and spring 2009 using a 14-item evaluation tool. Results Mean scores for 10 of the 14 individual items improved in a stepwise manner during the 3 years of the study. Items related to overall quality of the discharge summary showed statistically significant improvement, as did the portion of the summaries “carbon copied” to the responsible outpatient physician. Conclusions The quality of hospital discharge summaries improved following the implementation of a novel, structured program to teach chart documentation skills. Ongoing improvement was seen 1 and 2 years into the program, suggesting that continuing instruction in those skills was beneficial.

Analysis of an intervention on discharge summary quality and timeliness

2015 ◽  
Vol 3 (3) ◽  
pp. 362 ◽  
Author(s):  
Natalie Rose Mourra ◽  
Jason S Fish ◽  
Michael Adam Pfeffer
Keyword(s):  
Hospital Discharge ◽  
Discharge Summary ◽  
Monetary Incentive ◽  
Regression Modeling ◽  
Improvement Project ◽  
Patient Demographics ◽  
Time To Completion ◽  
The Impact ◽  
Discharge Summaries

Objective: Deficits in communication between inpatient and outpatient physicians in the post-hospital discharge period are common and potentially detrimental to person-centered doctor-patient relationships and to patient health. This study assesses the impact of a hospital discharge improvement project implemented at an urban academic hospital, aimed at improving the timeliness and quality of discharge summaries using a standardized discharge template, education and a small monetary incentive. Methods: A random sample of 624 charts from an academic, urban hospitalist medicine service was analyzed from the pre- and post-project implementation time periods: 2009-2010 and 2010-2011. The sampling was evenly distributed throughout the months of the year. Ordinary linear regression modeling was used to evaluate the impact of the intervention on time to completion; logistic regression modeling was used to assess the impact on the quality of the discharge summaries. Both models control for patient characteristics, hospitalization acuity and in-hospital continuity of care.Results: Unadjusted time to discharge summary completion rates decreased by 2.4 days (p<0.001) between the pre- and post-implementation times. Controlling for patient demographics, acuity of hospitalization and hand-offs between physicians, time to completion of discharge summaries was decreased by 2.17 days (p< 0.001). The odds of including at least 50% of the recommended information into a discharge summary post-intervention was 6.44 (p<0.001) compared to the odds before the intervention, controlling for patient demographics, acuity of hospitalization and hand-offs between physicians. Conclusion: The use of education, a simple formatted recommended discharge template and a small monetary incentive improved both the timeliness and quality of the information exchanged between inpatient and outpatient providers and contributes significantly to a person-centered healthcare.

The effects of a ‘discharge time-out’ on the quality of hospital discharge summaries

2012 ◽  
Vol 21 (10) ◽  
pp. 885-890 ◽  
Author(s):  
Namita Mohta ◽  
Prashant Vaishnava ◽  
Cathy Liang ◽  
Kye Ye ◽  
Matt Vitale ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Discharge Time ◽  
Time Out ◽  
Discharge Summaries
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