June 17, 2020
Physicians and other practitioners need to know details about the care a patient receives during an inpatient hospital stay. Discharge summaries are an invaluable resource that may improve patient outcomes by providing for continuity and coordination of care and a safe transition to other care settings and providers.
Improving the Discharge Process: Researchers in the field of transitions of care look at approaches to improve the discharge process. They categorize interventions as:
- Pre-discharge interventions including patient education, discharge planning, medication reconciliation and scheduling a follow-up appointment;
- Post-discharge interventions involving a follow-up phone call, communication with the ambulatory provider or home visits;
- Bridging interventions including transition coaches, patient-centered discharge instructions and clinician continuity between inpatient and outpatient settings.
Important Elements: The primary mode of communication between the hospital care team and aftercare providers is often the discharge summary, raising the importance of successful transmission of this document in a timely manner. Important elements in the discharge summary, as mandated by the Centers for Medicare and Medicaid Services, are:
- The outcome of the hospitalization
- The disposition of the patient
- Provisions for follow-up care including appointments, statements of how care needs will be met, and plans for additional services (e.g., hospice, home health assistance, skilled nursing)
It is critical to include this information to the aftercare providers. An essential component is identifying those laboratory or other tests for which final results remain pending at the time of discharge1.
Provider Survey Results: The Blue Cross and Blue Shield of Texas (BCBSTX) Provider Satisfaction Survey includes questions about PCPs’ satisfaction with hospital discharge summaries. In 2019, we saw an increase in PCPs who received a hospital discharge summary compared to 2018. Of those received, the timeliness and content remained consistent and overall satisfaction with continuity of care remained the same. The results demonstrate opportunities for improvement, but most importantly making sure the PCP receives a discharge summary.
BCBSTX Provider Satisfaction Survey – Hospital Discharge Summary Feedback
2017 (Goal 90%)
2018 (Goal 90%)
2019 (Goal 90%)
|When your patients are admitted to a hospital, are you sent summary information after the discharge?||72%||59%||67%|
|When you receive hospital discharge information, does it reach your office within a timely manner?||83%||83%||83%|
|When you receive hospital discharge information, does it contain adequate information about medications at discharge?||87%||89%||86%|
|Overall satisfaction with continuity of care||74%||79%||79%|
Communications via the discharge summary provides a smooth and long-lasting transition of the patient to the next level of care and avoid miscommunication or delays in care that may lead to poor outcomes.
We applaud practitioners that have adopted a structured approach to discharge summaries and strongly encourages those who have not, to consider adopting this practice.
1. Hospital discharge and readmission [Online] / auth. Eric Alper MD, Terrence A O'Malley, MD, Jeffrey Greenwald, MD // UpToDate. - January 2019. - https://www.uptodate.com/contents/hospital-discharge-and-readmission#H11.