Discharge Summary Completion Timeliness and the Association of 30-Day Readmission

Abstract

Objective: This study aimed to review the association between timeliness to completion of a discharge summary to 30-day readmission to the hospital.Methods: This was a retrospective chart review of 109 patients discharged from Mayo Clinic Hospital.Results: Twenty-four of these patients were readmitted within 30 days. The time to completion of discharge summary was categorized for these readmissions to <72 hours: 15 (20%), between 72 hours and 7 days: 2 (11.1%), and >7 days: 7 (43.7%). There was no statistical significance for readmission for discharge summaries completed between 72 hours and 7 days compared with <72 hours (P = 0.44). There was statistical significance correlating readmission within 30 days to the discharge summary completed >7 days compared with <72 hours (P = 0.04).Conclusions: This study found that discharge summaries completed >7 days have an increased association with 30-day readmission rate.

Readmission rates and predictors of avoidable readmissions in older adults in a tertiary care centre

“…[ 4 ] Factors associated with readmission include improper discharge planning; failure to send the discharge plan to the primary care physician; poor follow-up practices, especially with primary care physicians; lack of social and community support; unclear instructions to patients on discharge; incomplete diagnosis; inadequately treated medical conditions; sub-optimal patient care; errors in medication reconciliation; drug interactions and side effects; frailty; malnutrition; severe chronic conditions; the persistence of underlying chronic conditions; lapses in communication between treating team members and the patient; poor management of self-care activities at home following discharge; inability in accessing health care and keeping appointments; incomplete patient education resulting in lack of awareness of whom to contact; where to go and how to manage symptoms at home; nosocomial infections; and poor adherence to medications due to cost or inaccessibility. [ 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 ] Contributory intrinsic factors include old age, high comorbidity burden, low literacy rate, low socio-economic status, and lack of social networks. [ 9 10 22 23 24 ] Patients discharged against medical advice are at a higher risk for early readmissions, usually within the first day following discharge (bounce-back readmissions).…”