Pre-formatted written discharge summary—a step towards quality assurance in the emergency department

D, Nagendra Naidu; Rajavelu, Parivalavan; Rajagopalan, Arjun

doi:10.1007/s12245-008-0077-4

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…Overall, the results reflect the limited similar research from India that has evidenced unstructured and deficient HCP-patient communication at the point of discharge. [32,35] They are also consistent with other LMIC-based studies that, via patient reports and record evaluations, have evidenced a lack of in-depth information provision during discharge and/or poor levels of patient understanding regarding post-discharge care requirements. [27][28][29][30] The provision of deficient documented discharge information may be of particular concern for patient self-management, as global literature (predominantly from high-income countries) has indicated that individuals can struggle to absorb the verbal information provided by HCPs during healthcare consultations.…”

Section: Plos Onesupporting

confidence: 84%

“…[64][65][66][67][68] Given the predominantly paper-based systems in use across the study settings, well-structured and standardised HCP checklists, documents and patient-held record booklets are also likely to advance the quantity and quality of essential information transferred between HCPs and between HCPs and patients and have proven successful in HIC and LMIC settings. [35,[69][70][71] Co-creation of such materials with HCPs, patients, carers and other key stakeholders should be considered in order to enhance acceptability, function and utilisation.…”

Section: Next Stepsmentioning

confidence: 99%

“…[32][33][34] In addition, a study in an Indian hospital emergency department reported improvements in recorded discharge information following the implementation of pre-formatted discharge summaries. [35] The importance of investigating factors affecting continuity of care in LMICs and India, in particular, is increasing due to the rising prevalence of chronic NCDs, which require sustained care across settings. [36] Given the resource constraints across numerous LMIC settings, the need to elucidate context-relevant strategies to improve patient self-management and avoid unnecessary healthcare utilisation is also vital.…”

Section: Introductionmentioning

confidence: 99%

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Investigating discharge communication for chronic disease patients in three hospitals in India

et al. 2020

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Poor discharge communication is associated with negative health outcomes in high-income countries. However, quality of discharge communication has received little attention in India and many other low and middle-income countries. Primary objective To investigate verbal and documented discharge communication for chronic non-communicable disease (NCD) patients. Secondary objective To explore the relationship between quality of discharge communication and health outcomes. Methods Design Prospective study. Setting Three public hospitals in Himachal Pradesh and Kerala states, India.

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Section: Plos Onesupporting

confidence: 84%

Section: Next Stepsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigating discharge communication for chronic disease patients in three hospitals in India

et al. 2020

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“…A recent (2019) study from South Africa has found inadequate discharge planning to be a significant contributor to avoidable causes of hospital readmission 13. Across India, a handful of predominantly single-site studies have evaluated and described deficiencies in information exchange during referrals, hospital shift change and discharge 14–19. The current study forms part of a series completed for a project investigating handover and continuity of care for patients with chronic NCDs in the states of Kerala and Himachal Pradesh in India.…”

Section: Introductionmentioning

confidence: 98%

Patient and healthcare provider knowledge, attitudes and barriers to handover and healthcare communication during chronic disease inpatient care in India: a qualitative exploratory study

et al. 2019

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Objectives1) To investigate patient and healthcare provider (HCP) knowledge, attitudes and barriers to handover and healthcare communication during inpatient care. 2) To explore potential interventions for improving the storage and transfer of healthcare information.DesignQualitative study comprising 41 semi-structured, individual interviews and a thematic analysis using the Framework Method with analyst triangulation.SettingThree public hospitals in Himachal Pradesh and Kerala, India.ParticipantsParticipants included 20 male (n=10) and female (n=10) patients with chronic non-communicable disease (NCD) and 21 male (n=15) and female (n=6) HCPs. Purposive sampling was used to identify patients with chronic NCDs (cardiovascular disease, chronic respiratory disease, diabetes or hypertension) and HCPs.ResultsPatient themes were (1) public healthcare service characteristics, (2) HCP to patient communication and (3) attitudes regarding medical information. HCP themes were (1) system factors, (2) information exchange practices and (3) quality improvement strategies. Both patients and HCPs recognised public healthcare constraints that increased pressure on hospitals and subsequently limited consultation times. Systemic issues reported by HCPs were a lack of formal handover systems, training and accessible hospital-based records. Healthcare management communication during admission was inconsistent and lacked patient-centredness, evidenced by varying reports of patient information received and some dissatisfaction with lifestyle advice. HCPs reported that the duty of writing discharge notes was passed from senior doctors to interns or nurses during busy periods. A nurse reported providing predominantly verbal discharge instructions to patients. Patient-held medical documents facilitated information exchange between HCPs, but doctors reported that they were not always transported. HCPs and patients expressed positive views towards the idea of introducing patient-held booklets to improve the organisation and transfer of medical documents.ConclusionsHandover and healthcare communication during chronic NCD inpatient care is currently suboptimal. Structured information exchange systems and HCP training are required to improve continuity and safety of care during critical transitions such as referral and discharge. Our findings suggest that patient-held booklets may also assist in enhancing handover and patient-centred practices.

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“…Studies carried out in the emergency department (ED) setting have demonstrated that the provision of discharge information via a discharge summary in conjunction with verbal instructions improves both patient understanding of self-care at home and management of their medical issue (1)(2)(3)(4). Previously, discharge summaries and the provision of discharge instructions to patients being discharged from the ED was not a standardised practice in our institution.…”

Section: Introductionmentioning

confidence: 99%

Improvement of Communication with Primary Care Practitioners with The Use of Emergency Department Discharge Summaries

Ramasubbu¹,

Yap²,

Elgammal³

et al. 2014

JAEM

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Objective: To assess the quality of documentation and the frequency of provision of discharge summaries to general practitioners (GP) for patients discharged from our emergency department (ED). Material and Methods: The ED records of 50 patients who presented to the ED and who had been discharged to self-care or the care of their GP on an arbitrarily chosen day were selected for auditing. A pre-formatted computerised discharge summary was then introduced to the ED and the first 50 consecutive electronic discharge summaries of patients who visited the ED were selected for auditing. Results: In the first audit cycle, a diagnosis was documented in 78% of cases. Documentation of key investigation results was present in 84% of cases. Documentation that a prescription was provided to the patient was present in 46% of cases. Documentation of appropriate follow-up care and self-care instructions was demonstrated in 68% and 50% of cases. Of those discharged to GP care, none had documentation that a GP letter was sent or a copy attached. Second cycle: GP correspondence letters were sent and a copy saved in all cases. A diagnosis, follow-up care plan and results of key investigations were documented in 100% of discharge summaries. Self-care instructions on discharge were documented in 94% of cases. Conclusion: The introduction of electronic discharge summaries improved the quality and safety of the discharge process within our emergency department and paves the way for further improvements in information transfer technology.

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Pre-formatted written discharge summary—a step towards quality assurance in the emergency department

Cited by 12 publications

References 18 publications

Investigating discharge communication for chronic disease patients in three hospitals in India

Investigating discharge communication for chronic disease patients in three hospitals in India

Patient and healthcare provider knowledge, attitudes and barriers to handover and healthcare communication during chronic disease inpatient care in India: a qualitative exploratory study

Improvement of Communication with Primary Care Practitioners with The Use of Emergency Department Discharge Summaries

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