Evaluating Communication Between Pediatric Primary Care Physicians and Hospitalists

Abstract

To determine the preferences for and satisfaction with communication between pediatric primary care physicians (PCPs) and hospitalists, 2 surveys (PCP and hospitalist versions with matching questions) were developed. Overall, PCPs were less satisfied than hospitalists with communication (P < .01). The 2 provider types had differing opinions on responsibility for care after hospital discharge, with hospitalists more likely than PCPs to assign responsibility to the PCP for pending labs (65% vs 49%; P < .01), adverse events (85% vs 67%; P < .01), or status changes (85% vs 69%; P < .01). Whereas satisfaction with and preferences for patient-related communication differed between hospitalists and PCPs, the incongruent views on the responsibility for care after patient discharge have major implications for safety particularly if poor communication occurs at discharge. Successful transitions from the hospital to primary care require communication between hospitalists and PCPs to be consistent, timely, and informative with responsibility for care discussed at discharge.

Pediatric Hospitalists Collaborate to Improve Timeliness of Discharge Communication

“…This topic has been incompletely explored within pediatrics although the evidence suggests that expectations differ between hospitalists and PCPs with regard to certain aspects of this communication. 17 Patient-and family-centered outcomes were similarly not included and represent a more global gap in care coordination research, particularly for families that are unable to identify a medical home. Exploring PCP expectations and family-centered outcomes for improving hospital-based discharge transitions of care is a planned next phase of this work.…”

The Family Perspective on Hospital to Home Transitions: A Qualitative Study

“…[11][12][13] Other consequences include emergency department revisits, medication errors, primary care provider dissatisfaction with communication or confusion regarding discharge care responsibilities, patient or family dissatisfaction, and unanticipated out-of-pocket costs. [14][15][16][17][18][19][20] Current care delivery models propagate fragmented transition processes that place undue burdens on patients, families, and the health care system. The importance of successful transitions is recognized by leading academic societies in medicine, pediatrics, and nursing.…”

Linking Patient-Centered Medical Home and Asthma Measures Reduces Hospital Readmission Rates

“…Many problems have been attributed to the lack of continuity from the inpatient to outpatient settings, reinforcing the value of good communication between hospital-based and primary care providers. [11][12][13][14][15][16] Moreover, the follow-up visit after hospitalization provides the primary care provider (PCP) with an opportunity to track the progress from admission to discharge, provide proper follow-up assessment and treatment, and reinforce asthma education initiated during hospitalization. Thus, CAC-3 provides linkage to the patient-centered medical home (PCMH) from the inpatient setting, which is particularly critical given the chronic nature of this disorder.…”