OBJECTIVE: To compare the initial diagnosis of cases presented at morning report with the final morning report diagnosis reached at discharge from the Medicine service and the diagnosis as evaluated 6 months after discharge. DESIGN: Prospective cohort study of morning report cases. SETTING: A university internal medicine residency program. MEASUREMENTS: Proportion of morning report cases in which the initial morning report diagnosis differed from the final morning report diagnosis at discharge or, in cases where a firm diagnosis was not reached at discharge, the proportion for which a diagnosis was established by 6 months after discharge. MAIN RESULTS: In 24% of cases, a firm morning report diagnosis was not available at discharge. For 61% of these, a diagnosis could be established by 6-month follow-up: for 36% the diagnosis differed from the final morning report diagnosis; and for 25% it was the same. Among cases where a firm final diagnosis was reached during morning report, the initial morning report diagnosis differed for 17%. CONCLUSIONS: Most patients discharged without a firm diagnosis have one established by 6 months later--often with surprising results. Postdischarge follow-up information could enhance the educational value of inpatient cases.
OBJECTIVE: To compare the initial diagnosis of cases presented at morning report with the final morning report diagnosis reached at discharge from the Medicine service and the diagnosis as evaluated 6 months after discharge. DESIGN: Prospective cohort study of morning report cases. SETTING: A university internal medicine residency program. MEASUREMENTS: Proportion of morning report cases in which the initial morning report diagnosis differed from the final morning report diagnosis at discharge or, in cases where a firm diagnosis was not reached at discharge, the proportion for which a diagnosis was established by 6 months after discharge. MAIN RESULTS: In 24% of cases, a firm morning report diagnosis was not available at discharge. For 61% of these, a diagnosis could be established by 6-month follow-up: for 36% the diagnosis differed from the final morning report diagnosis; and for 25% it was the same. Among cases where a firm final diagnosis was reached during morning report, the initial morning report diagnosis differed for 17%. CONCLUSIONS: Most patients discharged without a firm diagnosis have one established by 6 months later--often with surprising results. Postdischarge follow-up information could enhance the educational value of inpatient cases.
Authors: Eric S Holmboe; Judith L Bowen; Michael Green; Jessica Gregg; Lorenzo DiFrancesco; Eileen Reynolds; Patrick Alguire; David Battinelli; Catherine Lucey; Daniel Duffy Journal: J Gen Intern Med Date: 2005-12 Impact factor: 5.128
Authors: Daniel E Banks; Runhua Shi; Donna F Timm; Kerri Ann Christopher; David Charles Duggar; Marianne Comegys; Jerry McLarty Journal: J Med Libr Assoc Date: 2007-10