Oct. 29, 2021
It is important for primary care providers (PCPs) to know details about the care their patients receive during inpatient hospital stays. The hospital discharge summary is the key source for this information. The Blue Cross Blue Shield of Texas (BCBSTX) 2021 PCP and specialist satisfaction survey results showed improvements in receiving the hospital discharge summary but there are still some providers not receiving them. It is important to communicate timely and ensure continuity of care for our Federal Employee Program® (FEP®) members to transition home or to the next level of treatment. The discharge summary is not only used to improve coordination and quality of care, but ultimately to reduce the number of preventable readmissions. Additional guidance for discharge planning was published in 2019 by the Centers for Medicaid and Medicare Services (CMS).
As a reminder, use of Electronic Health Records (EHRs), including wider acceptance of member portals when available, ensures smooth flow of information from the hospital when discharging FEP members to the next level of care. Supporting the member’s transition includes providing culturally appropriate member instructions, medication reconciliation and educating caregivers.
Studies have shown that providing timely, structured discharge summaries to PCPs helps reduce readmission rates, improves patient satisfaction, and supports continuity of care. One study found that, at discharge, approximately 40 percent of patients typically have test results pending and 10 percent of those results require action. PCPs and patients may be unaware of these results.1,3
One study found that one in five patients discharged from the hospital to their homes experienced an adverse event (defined as an injury resulting from medical management rather than from the underlying disease) within three weeks of discharge. This study found 66 percent of these were drug-related adverse events.2,3
As a reminder, please include the following information in every discharge summary:
- Course of treatment
- Diagnostic test results Follow-up plans
- Diagnostic test results pending at discharge
- Discharge medications with reasons for changes/medication reconciliation
FEP Case Management staff are available to work with members, providers and collaborate with medical teams while inpatient and post discharge to facilitate discharge planning instruction. BCBSTX and FEP applaud PCPs who have adopted the best practice of utilizing written discharge summaries along with medication reconciliation from their inpatient admission.
3Snow, V., MD. (2009). Transitions of Care Consensus Policy Statement: American College of Physicians, Society of General Internal Medicine, Society of Hospital Medicine, American Geriatrics Society, American College of Emergency Physicians, and Society for Academic Emergency Medicine. Journal of Hospital Medicine, 4(6), 364-370. doi:10.1002
The information in this article is being provided for educational purposes only and is not the provision of medical care or advice. Physicians and other health care providers are to their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.