B Tan1, B Mulo2, M Skinner3. 1. Joondalup Health Campus. 2. Sir Charles Gairdner Hospital, Western Australia, Australia. 3. Department of General Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Abstract
BACKGROUND: Discharge summaries remain a critical communication tool with primary care physicians. In a previous study of over 200 general medicine discharge summaries, we demonstrated that only 50% contain information regarding the indication and follow up required of any medicine changes on discharge. AIM: In this follow up pilot study, we assess the role of feedback and token incentives in improving discharge documentation. METHODS: Over a 14-week period, we randomly audited a selection of discharge summaries on a fortnightly basis. The results of these audits were fed back to the junior medical staff who compiled these summaries. If over 80% of the audited discharge summaries adequately documented the indication, with required follow up for new medication changes, junior doctors were provided with a token, non-monetary incentive for their efforts. At the end of the study period, we then conducted a survey of the junior doctors involved and collected feedback regarding their impressions of the study. RESULTS: Over the study period, 722 discharge summaries were completed and eligible for analysis. Over this time, mean appropriate documentation regarding medicine indication improved by 32%, and follow-up documentation improved by 10%. Overall, the participants felt the interventions were beneficial and that they should be continued beyond the study period. CONCLUSIONS: Education coupled with regular feedback and non-monetary incentives can potentially lead to improvements in the quality of discharge summaries.
BACKGROUND: Discharge summaries remain a critical communication tool with primary care physicians. In a previous study of over 200 general medicine discharge summaries, we demonstrated that only 50% contain information regarding the indication and follow up required of any medicine changes on discharge. AIM: In this follow up pilot study, we assess the role of feedback and token incentives in improving discharge documentation. METHODS: Over a 14-week period, we randomly audited a selection of discharge summaries on a fortnightly basis. The results of these audits were fed back to the junior medical staff who compiled these summaries. If over 80% of the audited discharge summaries adequately documented the indication, with required follow up for new medication changes, junior doctors were provided with a token, non-monetary incentive for their efforts. At the end of the study period, we then conducted a survey of the junior doctors involved and collected feedback regarding their impressions of the study. RESULTS: Over the study period, 722 discharge summaries were completed and eligible for analysis. Over this time, mean appropriate documentation regarding medicine indication improved by 32%, and follow-up documentation improved by 10%. Overall, the participants felt the interventions were beneficial and that they should be continued beyond the study period. CONCLUSIONS: Education coupled with regular feedback and non-monetary incentives can potentially lead to improvements in the quality of discharge summaries.
Authors: Natalie Wiebe; Lucia Otero Varela; Daniel J Niven; Paul E Ronksley; Nicolas Iragorri; Hude Quan Journal: J Am Med Inform Assoc Date: 2019-11-01 Impact factor: 4.497