Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service

Singh, Grace M; Harvey, Robert T.; Dyne, A.; Said, A.; Scott, Ian A

doi:10.1111/imj.12924

Cited by 5 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it differs from the abovementioned approaches and other previously described curricular innovations centered around teaching trainees the essentials of discharge summary preparation or use of discharge summary scorecards. 8,16 The expected length of stay in our study did not improve, which was in opposition to our original hypothesis. We suspect this was because the models used already accounted for the variables documented with the discharge diagnosis template and the template did not include variables specific to expected LOS, as we had assessed the most common and highest weighted variables across the three domains of cost, LOS and mortality.…”

Section: Discussioncontrasting

confidence: 99%

See 1 more Smart Citation

Optimizing Neurology Inpatient Documentation: A Pilot Study of a Novel Discharge Documentation EHR Tool

Kerbel

O’Brien

et al. 2023

The Neurohospitalist

View full text Add to dashboard Cite

Background and Purpose Clinical documentation of patient acuity is a major determinant of payer reimbursement. This project aimed to improve case mix index (CMI) by incorporating a novel electronic health record (EHR) discharge documentation tool into the inpatient general neurology service at the University of California, Los Angeles (UCLA) Medical Center. Methods We used data from Vizient AMC Hospital: Risk Model Summary for Clinical Data Base (CBD) 2017 to create a discharge diagnosis documentation tool consisting of dropdown menus to better capture relevant secondary diagnoses and comorbidities. After implementation of this tool, we compared pre- (July 2017-June 2019) and post-intervention (July 2019-June 2021) time periods on mean expected length of stay (LOS) and mean CMI with two sample T-tests and the percentage of encounters classified as having Major Complications/Comorbidities (MCC), with Complication/Comorbidity (CC), and without CC/MCC with tests of proportions. Results Mean CMI increased significantly from 1.2 pre-intervention to 1.4 post-intervention implementation ( P < .01). There was a pattern of increased MCC percentages for “Bacterial infections,” “Other Disorders of Nervous System”, “Multiple Sclerosis,” and “Nervous System Neoplasms” diagnosis related groups post-intervention. Conclusions This pilot study describes the creation of an innovative EHR discharge diagnosis documentation tool in collaboration with neurology healthcare providers, the clinical documentation improvement team, and neuro-informaticists. This novel discharge diagnosis documentation tool demonstrates promise in increasing CMI, shifting diagnosis related groups to a greater proportion of those with MCC, and improving the quality of clinical documentation.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Optimizing Neurology Inpatient Documentation: A Pilot Study of a Novel Discharge Documentation EHR Tool

Kerbel

O’Brien

et al. 2023

The Neurohospitalist

View full text Add to dashboard Cite

show abstract

“…17,18 Techniques employed have ranged from the provision of one-off and regular teaching sessions to clinicians through to programmes providing both teaching and feedback. [19][20][21][22][23] Importantly, it has been shown that the results of these QIPs can be long-lasting. 24 Additionally, the Royal College of Physicians has provided guidance on how to improve discharge summaries, which can be utilised when designing teaching on this subject.…”

Section: Discussionmentioning

confidence: 99%

Improving the quality of discharge summaries through a direct feedback system

Earnshaw

Pedersen

Evans

et al. 2020

Future Healthcare Journal

View full text Add to dashboard Cite

Introduction There is a recognised need to improve the quality of discharge documentation to facilitate the safe and effective ongoing care of patients once they leave hospital. Previous studies have focused on individual interventions, such as teaching or feedback. Our continuous quality improvement project aims to improve the quality of discharge documentation at our hospital by providing a comprehensive overhaul of the education and feedback around discharge documentation. Methods We designed a comprehensive data analysis tool to analyse the performance of our discharge summaries. We presented at clinical governance sessions and arranged numerous teaching sessions for junior doctors. We developed a livefeedback system based on the content of a sample set of the previous month's summaries, which included poster-based feedback and group teaching. Results Our interventions have significantly improved the quality of our discharge documentation across a broad range of categories, including the summary of the stay, actions for general practitioners and information given to patients in lay terminology. Conclusion Our comprehensive quality improvement project has improved the quality of our discharge documentation. Further work aims to expand this project into a regional setting, as well as designing a strategy to maintain engagement of key stakeholders to ensure continued progress.

show abstract

“…In our previous work, we found that discharge summaries prepared by fourth-year medical students demonstrated frequent errors and omissions, emphasizing the need for early, standardized education [6]. Published curricula have been feasible to implement and improved trainees' competence; however, programs have struggled with sustainability and delivery of personalized feedback [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A novel curriculum to train physician assistant students how to write effective discharge summaries

Zietlow

Gillum²,

Stouder

et al. 2019

Medical Education Online

View full text Add to dashboard Cite

Background: Physician assistants (PAs) are an integral part of inpatient care teams, but many PAs do not receive formal education on authoring discharge summaries. High-quality discharge summaries can mitigate patient risk during transitions of care by improving interprovider communication. Objective: To understand the current state of discharge summary education at our institution, and describe a novel curriculum to teach PA students to write effective discharge summaries. Design: Students completed a pre-survey to assess both knowledge and comfort levels regarding discharge summaries. They wrote a discharge summary and received feedback from two evaluators, an inpatient provider (IPP) familiar with the described patient and a simulated primary care provider (PCP). Students completed a post-survey reassessing knowledge and comfort. Results: Prior to instituting this curriculum, the majority of students (92.9%) reported rarely or never receiving feedback on discharge summaries. Eighty-four of 88 (95.5%) eligible students participated. There was discordance between IPP and simulated PCP feedback on their assessment of the quality of discharge summaries; simulated PCPs gave significantly lower global quality ratings (7.9 versus 8.5 out of 10, p = 0.006). Key elements were missing from >10% of discharge summaries. Student response was favorable. Conclusion: Clinically relevant deficiencies were common in students' discharge summaries, highlighting the need for earlier, structured training. IPPs and simulated PCPs gave discordant feedback, emphasizing differing needs of different providers during transitions of care. This novel curriculum improved students' knowledge and confidence.

show abstract

Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service

Cited by 5 publications

References 14 publications

Optimizing Neurology Inpatient Documentation: A Pilot Study of a Novel Discharge Documentation EHR Tool

Optimizing Neurology Inpatient Documentation: A Pilot Study of a Novel Discharge Documentation EHR Tool

Improving the quality of discharge summaries through a direct feedback system

A novel curriculum to train physician assistant students how to write effective discharge summaries

Contact Info

Product

Resources

About