Information Transfer and the Hospital Discharge Summary: National Primary Care Provider Perspectives of Challenges and Opportunities

Robelia, Paul M.; Kashiwagi, Deanne T.; Jenkins, Sarah M.; Newman, James S.; Sorita, Atsushi

doi:10.3122/jabfm.2017.06.170194

Cited by 30 publications

(40 citation statements)

References 12 publications

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“…A major benefit of the discharge summary was the medication information according to our participants, which is in line with the views of GPs in previous studies by Karapinar [ 9 ], Robelia [ 32 ] and also by Yemm et al, who compared GPs and hospital junior doctors’ opinions of the discharge summary [ 13 ]. Accuracy was most important for both groups [ 13 ], which is in line with our study.…”

Section: Discussionsupporting

confidence: 89%

“…Furthermore, a great deal of distrust was expressed by our participants, often due to poor discharge summary quality. Deficient discharge information is previously commonly noted, mainly regarding medication information [ 11 , 12 , 32 , 34 ] and follow-up plans [ 10 , 12 ]. Such shortcomings may affect the quality of care at follow-up [ 12 ] and dissatisfy the GPs [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Drugs, distrust and dialogue –a focus group study with Swedish GPs on discharge summary use in primary care

et al. 2018

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BackgroundDischarge summary with medication report effectively counteracts drug-related problems due to insufficient information transfer in care transitions. The benefits of the discharge summary may be lost if it is not adequately used, and factors affecting optimal use by the GP are of interest. Since the views of Swedish GPs are unexplored, this study aimed to explore and understand GPs experiences, perceptions and feelings regarding the use of the discharge summary with medication report.MethodThis qualitative study was based on four focus group discussion with 18 GPs and resident physicians in family medicine which were performed in 2016 and 2017. A semi-structured interview guide was used. The interviews were transcribed verbatim and analysed using qualitative content analysis.ResultsThe analysis resulted in three final main themes: “Importance of the discharge summary”, “Role of the GP” and “Create dialogue” with six categories; “Benefits for the GP and perceived benefits for the patient”, “GP use of the information”, “Significance of different documents”, “Spider in the web”, “Terminus/End station” and “Improved information transfer in care transitions”. Overall, the participants described clear benefits with the discharge summary when accurate although perceived deficiencies were also quite rife.ConclusionThe GPs experiences and views of the discharge summary revealed clear benefits regarding mainly medication information, awareness of any plans as well as shared knowledge with the patient. However, perceived deficiencies of the discharge summary affected its use by the GP and enhanced communication was called for.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Drugs, distrust and dialogue –a focus group study with Swedish GPs on discharge summary use in primary care

et al. 2018

View full text Add to dashboard Cite

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“…The primary form of communication between hospitalbased specialists and GP is the HDS, and receipt of the HDS by services and the assessment of its content have been previously used to assess the coordination and continuity of care. [44][45][46][47] For over two-thirds of patients who visited the PHC service for cancer-related care after their diagnosis, the visit occurred before a HDS was available in the patient's notes. Absence of timely communication between hospital-based specialists and GP through the HDS for many patients seeking care related to their cancer highlights difficulties that many PHC services endure in providing quality care.…”

Section: Discussionmentioning

confidence: 99%

“…Internal Medicine Journal 50 (2020) [38][39][40][41][42][43][44][45][46][47] may require early post-discharge follow up in primary care. Incomplete or delayed access to information by GP has been linked to preventable medical errors.…”

Section: Communication About Cancer In Primary Carementioning

confidence: 99%

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

Valery

Bernardes

Witt

et al. 2020

Internal Medicine Journal

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Background Cancer care involves many different healthcare providers. Delayed or inaccurate communication between specialists and general practitioners (GP) may negatively affect care. Aim To describe the pattern and variation of communication between primary healthcare (PHC) services and hospitals and specialists in relation to the patient's cancer care. Methods A retrospective audit of clinical records of Indigenous Australians diagnosed with cancer during 2010–2016 identified through 10 PHC services in Queensland is described. Poisson regression was used to model the dichotomous outcome availability of hospital discharge summary versus not. Results A total of 138 patient records was audited; 115 of those patients visited the PHC service for cancer‐related care after cancer diagnosis; 40.0% visited the service before a discharge summary was available, and 36.5% of the patients had no discharge summary in their medical notes. While most discharge summaries noted important information about the patient's cancer, 42.4% lacked details regarding the discharge medications regimen. Conclusions Deficits in communication and information transfer between specialists and GP may adversely affect patient care. Indigenous Australians are a relatively disadvantaged group that experience poor health outcomes and relatively poor access to care. The low proportion of discharge summaries noting discharge medication regimen is of concern among Indigenous Australians with cancer who have high comorbidity burden and low health literacy. Our findings provide an insight into some of the factors associated with quality of cancer care, and may provide guidance for focus areas for further research and improvement efforts.

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“…Academic family physicians providing obstetric care report concerns about the use of nicotine (in various forms) and marijuana during pregnancy; albeit most do not screen consistently for these substances. 7 Robelia et al 8 reports that the hospital discharge summary is still failing; despite all the electronic records and readily available methods for rapid information transfer, the receiving family physician often still is not provided key discharge information. Having access to the inpatient record helped with the insufficiency of information, but it seems like digging through a hospital record could take much more time than receiving a complete, organized, direct summary of the record.…”

Section: Commissions Omissions and Inadequate Information For Optimmentioning

confidence: 99%

Multiple Practical Facts and Ideas to Improve Family Medicine Care

Bowman¹,

Seehusen

Neale³

2017

J Am Board Fam Med

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Seconds count in a study on the best electronic health note format to reduce medical record charting time and increase accuracy. Directly observed family physician work is compared with Current Procedural Terminology (CPT) coding examples and notably under-recognized. This issue contains articles from single practices that that implemented new methods of care and other reports on practice innovations that can be more broadly implemented. We have articles on opioid medication use for acute low back pain in primary care, an electronic chronic pain consult service, a key question to identify potential opioid misuse risk, and newly implemented screening for other substances of abuse. Omissions (or gaps) in care are also highlighted: from the common types of omissions identified by primary care clinicians, self-reported low levels of substance use screening by family medicine prenatal care providers, and inadequate and inadequately available hospital discharge summaries. In addition, the most important alarm symptoms for a cancer diagnosis are reported. Seconds Count-How to Improve Electronic Health Records, and Thus Physicians' LivesIn the category of useful and practical, and some potential relief from the electronic health record (EHR) frustrations blamed for physician burnout, Belden et al 1 compared different EHR note formats (including some novel prototypes) by several excellent methods (audio, computer-screen activity, eye tracking, and field notes). The authors measured the actual time-on-task, as well as accuracy and effort. A reminder is that the few seconds' difference between the formats can add up quickly across many charts and visits. Some notes were collapsible in design. The proposed note prototypes performed better than the traditional Subjective, Objective, Assessment, Plan (SOAP) note format for speed, accuracy, and usability. It is worth looking at the appendices to see the actual note formats. Here's to having many individuals show this article to their EHR vendor! Care Innovation Reports from Single Family Medicine OfficesIn our lead article, Schwartz et al 2 discusses incorporating pharmacogenetics into a family practice for making medication decisions. A pharmacist completed medication reconciliation with patients taking a large number of medications and reviewed the completed pharmacogenetic testing, then made recommendations to the physician for medication changes. Drug-gene interactions were found a quarter of the time. In practice, I (MAB) have received pharmacogenetic reports ordered by psychiatrists for patients who have tried many different antidepressants without sufficient success. The reports seem to be useful for medication selection, but the full outcomes of pharmacogenetics on patient care are far from known. Axten et al 3 report on a novel wellness group visit model for obesity. A single family physician and collaborating dietician report on the success of this model, finding that much of the weight loss was sustained through 3 years of followup. See their excellent helpful hint...

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Information Transfer and the Hospital Discharge Summary: National Primary Care Provider Perspectives of Challenges and Opportunities

Cited by 30 publications

References 12 publications

Drugs, distrust and dialogue –a focus group study with Swedish GPs on discharge summary use in primary care

Drugs, distrust and dialogue –a focus group study with Swedish GPs on discharge summary use in primary care

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

Multiple Practical Facts and Ideas to Improve Family Medicine Care

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