Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice

Pathak, Sarita; Summerville, Gregory; Kaplan, Celia P.; Nouri, Sarah; Karliner, Leah

doi:10.1177/2374373519879286

Cited by 13 publications

(12 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The AVS has become an important tool for facilitating communication between patients and their providers. Although data on the utility of AVS in rheumatology clinics are lacking, one study from primary care suggested that 67.4% of patients consulted it, 45.9% consulted it more than once, and 31.6% shared the AVS 8 . However, numerous challenges exist to ensure that AVS' are patient-centered, modifiable, and nonburdensome for providers 9,10 .…”

Section: Resultsmentioning

confidence: 99%

“…Although data on the utility of AVS in rheumatology clinics are lacking, one study from primary care suggested that 67.4% of patients consulted it, 45.9% consulted it more than once, and 31.6% shared the AVS. 8 However, numerous challenges exist to ensure that AVS' are patient-centered, modifiable, and nonburdensome for providers. 9,10 Results from this quality improvement project help to understand features that would add to the patient-centeredness and providerfriendliness of an AVS.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences

Kumar

Zahn²,

Seeman³

et al. 2023

J Clin Rheumatol

View full text Add to dashboard Cite

BackgroundAfter-visit summaries (AVS) are patient-specific documents curated by providers to summarize the content of medical encounters. Despite widespread use, little is known about rheumatology patient preferences for AVS content and style. The aims of this quality improvement project are to identify patient preferences and to design a rheumatology-specific AVS, using the Kano method.MethodsThis quality improvement project consists of 4 parts. First, investigators interviewed veterans and clinic staff to derive a list of potential features. Second, a Kano questionnaire assessing satisfaction with the presence or absence of each feature was distributed to veterans. Third, qualitative and quantitative Kano analyses were performed to categorize features as mandatory, performance, attractive, or indifferent. Fourthly, based on these findings, an AVS was drafted and distributed to Veterans with an associated survey to assess satisfaction with content, visual appeal, and readability.ResultsNine physicians, 5 veterans, 5 schedulers, 3 nurses, and 3 medical assistants identified 15 features for inclusion in a Kano-style questionnaire. The questionnaire was distributed to 50 Veterans using consecutive sampling. Quantitative Kano analysis demonstrated 4 mandatory, 2 performance, and 3 attractive features that were ultimately included in the AVS; 6 indifferent features were excluded. A postintervention survey of 50 Veterans showed high satisfaction scores in AVS content (4.3/5), visual appeal (4.6/5), and readability (4.4/5).ConclusionsWe developed an AVS that included 9 mandatory, attractive, and performance features, as identified by the Kano method. Veterans were highly satisfied by the content, visual appeal, and readability of the AVS.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences

Kumar

Zahn²,

Seeman³

et al. 2023

J Clin Rheumatol

View full text Add to dashboard Cite

show abstract

“…However, the findings from our study demonstrate that written communication can enhance a surrogate’s understanding of verbal communication. Currently, numerous clinical settings outside the ICU use clinical summaries to facilitate a patient’s understanding of his or her health, to encourage more active participation in medical decision-making, and to help limit issues related to patient recall (19, 20). Studies have shown that these tools are a valuable means of communication from both the patient and provider point of view.…”

Section: Discussionmentioning

confidence: 99%

Written Care Summaries Facilitate Communication Between Families and Providers of ICU Patients: A Pilot Study

Bulger

Quinn

Glover

et al. 2021

Critical Care Explorations

View full text Add to dashboard Cite

OBJECTIVES: ICU providers may invite families to participate in daily rounds to inform them of the patient’s condition and to support their emotional well-being. Daily written summaries of care may provide complementary benefits. DESIGN: Qualitative interviews with surrogates of ICU patients who received daily written summaries of care. SETTING: Single, urban academic medical center. PATIENTS/SUBJECTS: A convenience sample of 30 surrogates of nondecisional, medical ICU patients. INTERVENTIONS: Daily written summaries detailed each of the patient’s main ICU problems, the presumed causes of each of the problems, and the medical team’s plan to address each of the problems for each ICU day. MEASUREMENTS AND MAIN RESULTS: There were four ways that written summaries affected the participant’s experience: 1) providing clarity to participants regarding the patient’s condition, 2) facilitating participant understanding of the patient’s clinical course, 3) facilitating communication between participants and medical providers, and 4) facilitating communication between participants and other family members. Overarching themes were that summaries were understandable, had appropriate level of detail, and added value to the ICU experience. CONCLUSIONS: In this pilot study, family members had positive impressions of receiving daily written summaries of care. Further study is needed to determine the extent to which written communication may affect family and patient outcomes.

show abstract

“…Patients have reported personalized free-text instructions as helpful and easy to understand. 4 The Centers for Medicare and Medicaid Services (CMS) created financial incentives for healthcare organizations to improve the use of the AVS tool as part of the meaningful use requirement within the Affordable Care Act. 5 The requirement included providing patients with an AVS with relevant and actionable information and instructions after each office visit.…”

Section: Introductionmentioning

confidence: 99%

A Quality Improvement Initiative to Improve After-visit Summary Distribution in Orthopedic Outpatient Clinics

Williamson

Holstine

Samora

2022

Pediatric Quality &Amp; Safety

View full text Add to dashboard Cite

Introduction: Communication and patient education are key to effective healthcare encounters and improved health outcomes. The after-visit summary (AVS) is an integral communication and education tool for patients and families. Without effective communication, gaps in comprehension may result in decreased satisfaction with medical encounters, lack of adherence to recommended treatment plans, missed appointments, and increased malpractice claims. Methods: We initiated a quality improvement (QI) initiative implementing concepts derived from the Institute for Healthcare Improvement (IHI) model, including plan-do-study-act cycles, to increase AVS distribution rates in a high-volume, fast-paced ambulatory pediatric orthopedic clinic. Interventions included staff education and training, trainee instruction, enlistment of electronic medical record superusers to enhance the distribution process, and provision of regular, transparent communication of individual and team performance. The impact of interventions was measured using a p-chart. Results: There was a consistent improvement in the rate of AVS distribution with each intervention implemented. The distribution rate on project initiation was 81.9%, with a final rate of 95.7%. The most statistically significant shift occurred following the final intervention, which included sharing unblinded individual performance data. Conclusion: Our data demonstrate that a dedicated QI program using IHI methodology improved AVS distribution rates in a pediatric orthopedic clinic. Consistently distributing the AVS affords our patients and families a better opportunity to review pertinent visit information, education, medication changes, and upcoming appointments.

show abstract

Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice

Cited by 13 publications

References 8 publications

What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences

What Do Rheumatology Patients Want in an After-Visit Summary? A Kano Analysis of Patient Preferences

Written Care Summaries Facilitate Communication Between Families and Providers of ICU Patients: A Pilot Study

A Quality Improvement Initiative to Improve After-visit Summary Distribution in Orthopedic Outpatient Clinics

Contact Info

Product

Resources

About