July 2018
The Keys to Unlocking a Great Discharge Summary
Physicians and other practitioners need to know details about the care a patient receives during an inpatient hospital stay. The hospital discharge summary is an invaluable source for this information. Discharge summaries may improve patient outcomes by providing for continuity and coordination of care, and a safe transition to other care settings and providers.
Mayo Clinic Study
In 2015, the Mayo Clinic conducted a study developed by a research group consisting of hospitalists and Primary Care Providers (PCPs). The study identified the top five elements of a discharge summary that PCPs perceived as being the most important.
- Medication list with changes - 94%
- List of diagnosis/problems - 89%
- Treatment provided - 87%
- Pending or completed lab and imaging results - 76%
- Ongoing care recommendations - 75%
In the discussion of the results, the study found that the hospital discharge summary serves as the main conduit for communication between inpatient and outpatient care teams. The study also found that PCPs continue to identify deficits in hospital discharge summary content and availability. The findings suggest that a hospital’s initial efforts should include ensuring availability of a complete summary at the posthospital follow-up visit. Improved outcomes during and after this critical transition of care will be a welcomed outcome by both patients and their care providers.
BCBSTX Provider Satisfaction Survey
The Blue Cross and Blue Shield of Texas (BCBSTX) Provider Satisfaction Survey includes questions about PCPs’ satisfaction with hospital discharge summaries. Results in 2017 declined compared to 2016 demonstrating opportunities for improvement in timeliness and content.
BCBSTX Provider Satisfaction Survey – Hospital Discharge Summary Feedback
| Survey Questions | 2015 (Goal 85%) |
2016 (Goal 90%) |
2017 (Goal 90%) |
| When your patients are admitted to a hospital, are you sent summary information after the discharge? | 72% | 80% | 72% |
| When you receive hospital discharge information, does it reach your office within a timely manner? | 80% | 84% | 83% |
| When you receive hospital discharge information, does it contain adequate information about medications at discharge? | 88% | 89% | 87% |
| Overall satisfaction with continuity of care | 76% | 80% | 74% |
Communications between a hospital and PCP are critical to providing a smooth and long-lasting transition of the patient to the next level of care. Continuity and coordination of care may avoid miscommunication or delays in care that may lead to poor outcomes.
BCBSTX applauds practitioners who have adopted a structured approach to discharge summaries and strongly encourages those who have not to consider adopting this practice.
Source:
Multiple Practical Facts and Ideas to Improve Family Medicine Care. J Am Board Fam Med Nov. 1, 2017, 30:687-690. Information Transfer and the Hospital Discharge Summary: National Primary Care Provider Perspectives of Challenges and Opportunities.