Wednesday, July 23, 2014
This Is An Obvious But Important Finding! Discharge Summaries Need To Arrive Promptly.
This appeared last week:
16 July, 2014 Michael Woodhead
The frustration GPs feel over late-arriving hospital discharge letters is justified, according to a new study that shows tardy communication impairs patient management.
Researchers in WA have measured the additional burden created by delayed discharge letters, finding that GPs are unable to adequately manage a discharged patient's problems until they receive the all-important discharge information.
The study showed that a timely but brief discharge letter was preferable to a longer letter that arrived after a discharged patient had attended their GP.
And delayed discharge letters often meant that patients had to revisit their GP.
Here is the abstract:
BMJ Open 2014;4:e005475 doi:10.1136/bmjopen-2014-005475
Objective To determine how the timing and length of hospital discharge letters impact on the number of ongoing patient problems identified by general practitioners (GPs).
Trial design GPs were randomised into four groups. Each viewed a video monologue of an actor-patient as he might present to his GP following a hospital admission with 10 problems. GPs were provided with a medical record as well as a long or short discharge letter, which was available when the video was viewed or 1 week later. GPs indicated if they would prescribe, refer or order tests for the patient's problems.
Results Numbers randomised 59 GPs. Recruitment GPs were recruited from a network of 102 GPs across Australia. Numbers analysed 59 GPs. Outcome GPs who received the long letter immediately were more satisfied with this information... see link below for details
Conclusions Receiving information during patient consultation, as well as GP characteristics, influences the number of patient problems addressed.
If ever there was a clear justification for using electronic messaging to get discharge summaries into the hands of GPs this is it. They need to be done on discharge and then transmitted directly. If the patient has a PCEHR they can go there as well - but the vital step is to use the secure message transmission to the GP that is already in place for results etc. in many, many practices. We know it works so it is hard to understand why it is not happening everywhere - other than the distraction that has afflicted us with the PCEHR Program.
It is interesting to note that simple and quick is seen as better than long but slower!
Posted by Dr David More MB PhD FACHI at Wednesday, July 23, 2014