Does a Standardized Discharge Communication Tool Improve Resident Performance and Overall Patient Satisfaction?

Dalley, Michael; Baca, Mauricio J; Raza, Chandelle; Boge, Laurie; Edwards, David; Goldszer, Robert C.; Cubeddu, Luigi X.; Farcy, David A.

doi:10.5811/westjem.2020.9.48604

Cited by 8 publications

(11 citation statements)

References 27 publications

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“…Studies have found that proper use of standardized discharge communication tools and practices improve discharge quality and satisfaction with the process. 24 , 25 Second, as opposed to a typical hospital discharge which is often rushed over several hours, our ACH discharge process happens over a number of days, ensuring proper patient education, medication reconciliation, and primary provider handoff and follow-up. We believe these two properties of our virtual hybrid model leave patients with confidence that they are ready for discharge as reflected in the high scores seen.…”

Section: Discussionmentioning

confidence: 99%

Overall patient experience with a virtual hybrid hospital at home program

et al. 2022

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Objectives: Traditional hospital at home models often have high patient experience scores. The purpose of this study is to look at the patient experience of a new virtual hybrid model of hospital at home called Advanced Care at Home. Methods: Patients in Mayo Clinic’s Advanced Care at Home program received a survey via email from 1 January–31 May 2021. Each survey consisted of 20 questions divided into 18 multiple-choice and two open-ended questions. Results: Ninety-nine surveys were sent and 41 partially or completely finished surveys were returned for a response rate of 41.4%. Patients responded positively, denoted by answering “strongly agree or somewhat agree,” with regard to the ability to reach the team right away 100% of the time, being kept informed 92% of the time, the command center responding promptly to their needs 95% of the time, the team providing comfort and support 98% of the time, feeling comfortable with interacting with their provider by phone or tablet 95% of the time, the ease of use from the equipment 97% of the time, the virtual and in-person staff working well together 98% of the time, the staff treating patients with courtesy and respect 100% of the time, and the ease of understanding the discharge process and feeling ready to leave the program 100% of the time. All providers received positive responses on listening ⩾88% of the time. Patients gave a top rating in likelihood to recommend the program 100% of the time. Conclusion: Overall, the Advanced Care at Home model of hospital at home was highly recommended by patients. Patients scored the program high on responsiveness, staff engagement and communication, ease of equipment use, and readiness for discharge, strengthening the overall confidence in this novel program.

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Section: Discussionmentioning

confidence: 99%

Overall patient experience with a virtual hybrid hospital at home program

et al. 2022

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“…[13][14][15] Junior residents often perform discharges, however formal resident physician education on the discharge process is rare, and residents commonly omit key components of the discharge conversation. 16 17 Dedicated education about discharge communication has been shown to improve resident discharge performance. 16 Therefore, academic centers that care for TACS patients should consider adding formal training on this subject.…”

Section: Discussionmentioning

confidence: 99%

“…16 17 Dedicated education about discharge communication has been shown to improve resident discharge performance. 16 Therefore, academic centers that care for TACS patients should consider adding formal training on this subject. In addition, the teach back method, during which a patient is asked to repeat information in their own words, should be emphasized.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have evaluated discharge communication specifically with TACS patients, but patients in general benefit from discharge information presented verbally in a structured manner, with confirmation of understanding before the patient leaves 13–15. Junior residents often perform discharges, however formal resident physician education on the discharge process is rare, and residents commonly omit key components of the discharge conversation 16 17. Dedicated education about discharge communication has been shown to improve resident discharge performance 16.…”

Section: Discussionmentioning

confidence: 99%

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Patient and clinician perceptions of the trauma and acute care surgery hospitalization discharge transition of care: a qualitative study

McFadden

Gosdin

Jurkovich

et al. 2022

Trauma Surg Acute Care Open

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ObjectivesTrauma and acute care surgery (TACS) patients face complex barriers associated with hospitalization discharge that hinder successful recovery. We sought to better understand the challenges in the discharge transition of care, which might suggest interventions that would optimize it.MethodsWe conducted a qualitative study of patient and clinician perceptions about the hospital discharge process at an urban level 1 trauma center. We performed semi-structured interviews that we recorded, transcribed, coded both deductively and inductively, and analyzed thematically. We enrolled patients and clinicians until we achieved data saturation.ResultsWe interviewed 10 patients and 10 clinicians. Most patients (70%) were male, and the mean age was 57±16 years. Clinicians included attending surgeons, residents, nurse practitioners, nurses, and case managers. Three themes emerged. (1) Communication (patient-clinician and clinician-clinician): clinicians understood that the discharge process malfunctions when communication with patients is not clear. Many patients discussed confusion about their discharge plan. Clinicians lamented that poorly written discharge summaries are an inadequate means of communication between inpatient and outpatient clinicians. (2) Discharge teaching and written instructions: patients appreciated discharge teaching but found written discharge instructions to be overwhelming and unhelpful. Clinicians preferred spending more time teaching patients and understood that written instructions contain too much jargon. (3) Outpatient care coordination: patients and clinicians identified difficulties with coordinating ongoing outpatient care. Both identified the patient’s primary care physician and insurance coverage as important determinants of the outpatient experience.ConclusionTACS patients face numerous challenges at hospitalization discharge. Clinicians struggle to effectively help their patients with this stressful transition. Future interventions should focus on improving communication with patients, active communication with a patient’s primary care physician, repurposing, and standardizing the discharge summary to serve primarily as a means of care coordination, and assisting the patient with navigating the transition.Level of evidenceIII—descriptive, exploratory study.

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“…A recent study suggests that using a standardized discharge communication tool can significantly improve patients' perceptions of the discharge conversation. This communication tool ensured that the patients were given information regarding diagnosis, test results, lifestyle changes, obstacles after discharge, prescribed medications, and follow-up plans after discharge 178 . The PCCQ could also be used as a checklist by nurses and physicians to ensure that the patient has been given all the relevant information.…”

Section: Perceived Continuity After Hospitalizationmentioning

confidence: 99%

Continuity of care after hospitalization due to cardiac conditions : Patients' perceptions, validity and reliability of a measure, and associations with outcomes

Säfström

2023

Linköping University Medical Dissertations

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Background: Cardiac conditions are a common cause of hospitalization worldwide. The need for healthcare continues after hospital discharge and most commonly includes follow-up within primary healthcare centers or specialized outpatient cardiology clinics. This transition from the hospital to outpatient or primary-care settings jeopardizes the continuity of care. Continuity of care refers to the coordination of healthcare between different healthcare personnel and settings over time. There are three types of continuity of care: informational, relational, and management continuity. Continuity of care is essential after hospitalization due to cardiac conditions, and is associated with several positive clinical outcomes; however, available patient-reported measures of continuity of care during the posthospital period needs further validation. Accurate measurements would improve our ability to evaluate implementations designed to enhance continuity of care. Moreover, there is a lack of knowledge about whether the associations between continuity of care, perceived control, and self-care could explain variations in health-related quality of life and hospital readmissions in patients with cardiac conditions. Aim:The overall aim of this thesis was to contribute to improving care after hospitalization for patients with cardiac conditions by describing continuity of care from the patient's perspective and increasing the understanding of how continuity of care can be measured and how it can influence patient outcomes. Method:All four studies had a cross-sectional design using a consecutive sampling procedure (I-IV). Study I was a single-center study and studies II-IV were multicenter studies. Data was collected using structured telephone interviews (I), questionnaires (II-IV), and review of medical charts (I-IV). The timescale for data collection ranged from one week (I) to six weeks after discharge (II-IV). The Patient Continuity of Care Questionnaire (PCCQ), a 27-item questionnaire to measure patients' perceptions of continuity of care, was translated and culturally adapted to Swedish. The factor structure was reviewed (II), and a short version including 12 of the items was evaluated (III). A conceptual model was constructed to examine the associations between continuity of care, perceived control, self-care, health-related quality of life, and hospital readmissions (IV). The data was analyzed using descriptive and non-parametric statistics (I), confirmatory factor analysis, test-retest estimation (II), the Rasch measurement model (III), and structural equation modeling (SEM) (IV).

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Does a Standardized Discharge Communication Tool Improve Resident Performance and Overall Patient Satisfaction?

Cited by 8 publications

References 27 publications

Overall patient experience with a virtual hybrid hospital at home program

Overall patient experience with a virtual hybrid hospital at home program

Patient and clinician perceptions of the trauma and acute care surgery hospitalization discharge transition of care: a qualitative study

Continuity of care after hospitalization due to cardiac conditions : Patients' perceptions, validity and reliability of a measure, and associations with outcomes

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