The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.
For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care. Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community. We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
209
The customized electronic discharge summary program will be used to generate patient discharge summaries.
St. Michael's Hospital
Toronto, Ontario, Canada
Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Time frame: Satisfaction score assessment form to be sent one week after patient's discharge from hospital. If form is not returned in 14 days, a reminder and second form will be sent.
St. Michael's Hospital housestaff satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Time frame: Housestaff will fill out form upon completion of the rotation during which the study has been performed
Completion of specialist outpatient workups at St. Michael's Hospital recommended during course of hospitalization
Time frame: Within the first 30 days of patient's discharge from hospital
Patient visits to Emergency Room at St. Michael's Hospital
Time frame: Within the first 30 days after patient's discharge from hospital
Patient/proxy care transition assessment through the use of the CTM-3.
Time frame: Phone call made to patient or proxy one week after discharge. If patient/proxy is not reached, follow up calls will be made daily until patient/proxy is reached.
Prescribing errors as assessed by comparing discharge summary to inpatient record
Time frame: Upon discharge
Patient readmissions to St. Michael's Hospital
Time frame: Within 30 days of discharge
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