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Hospital variation in quality of discharge summaries for patients hospitalized with heart failure exacerbation.
- Source :
-
Circulation. Cardiovascular quality and outcomes [Circ Cardiovasc Qual Outcomes] 2015 Jan; Vol. 8 (1), pp. 77-86. Date of Electronic Publication: 2015 Jan 13. - Publication Year :
- 2015
-
Abstract
- Background: Single-site studies have demonstrated inadequate quality of discharge summaries in timeliness, transmission, and content, potentially contributing to adverse outcomes. However, degree of hospital-level variation in discharge summary quality for patients hospitalized with heart failure (HF) is uncertain.<br />Methods and Results: We analyzed discharge summaries of patients enrolled in the Telemonitoring to Improve Heart Failure Outcomes (Tele-HF) study. We assessed hospital-level performance on timeliness (fraction of summaries completed on the day of discharge), documented transmission to the follow-up physician, and content (presence of components suggested by the Transitions of Care Consensus Conference). We obtained 1501 discharge summaries from 1640 (91.5%) patients discharged alive from 46 hospitals. Among hospitals contributing ≥ 10 summaries, the median hospital dictated 69.2% of discharge summaries on the day of discharge (range, 0.0%-98.0%; P<0.001); documented transmission of 33.3% of summaries to the follow-up physician (range, 0.0%-75.7%; P<0.001); and included 3.6 of 7 Transitions of Care Consensus Conference elements (range, 2.9-4.5; P<0.001). Hospital course was typically included (97.2%), but summaries were less likely to include discharge condition (30.7%), discharge volume status (16.0%), or discharge weight (15.7%). No discharge summary included all 7 Transitions of Care Consensus Conference-endorsed content elements, was dictated on the day of discharge, and was sent to a follow-up physician.<br />Conclusions: Even at the highest performing hospital, discharge summary quality is insufficient in terms of timeliness, transmission, and content. Improvements in all aspects of discharge summary quality are necessary to enable the discharge summary to serve as an effective transitional care tool.<br /> (© 2015 American Heart Association, Inc.)
- Subjects :
- Disease Progression
Heart Failure diagnosis
Humans
Information Dissemination
Telemedicine standards
Time Factors
United States
Continuity of Patient Care standards
Healthcare Disparities standards
Heart Failure therapy
Hospitalization
Hospitals standards
Patient Discharge standards
Patient Discharge Summaries standards
Quality Indicators, Health Care standards
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7705
- Volume :
- 8
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular quality and outcomes
- Publication Type :
- Academic Journal
- Accession number :
- 25587091
- Full Text :
- https://doi.org/10.1161/CIRCOUTCOMES.114.001227