Completed discharge summaries reduce readmission risk

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Complete and timely discharge summaries can help prevent readmissions and improve patient safety, suggests a study published in the Journal of General Internal Medicine.

Joint Commission-accredited organizations must submit discharge summaries within 30 days after a hospital discharges a patient. Researchers at the University of Wisconsin School of Medicine and Public Health, however, found that reports from hospitals to nursing homes often are incomplete or delayed. In fact, as more time passed, the quality of the discharge summary degraded, failing to include the important information on diet, activity level, therapy and pending laboratory tests, according to a press release yesterday.

"Our study is the first to suggest that the quality of the actual document starts getting worse the longer you wait to create a discharge summary. Important items are omitted, and because of that, patient care may suffer," lead study author Dr. Amy Kind, assistant professor of medicine in the geriatrics division, said in the press release.

In the study, discharge summaries, which are often the primary template for guiding the care of patients after leaving the hospital, failed to include dietary needs a third of the time, therapy and activity needs in 40 percent of the summaries, and pending studies and laboratory tests in 10 percent of the cases.

Although the study didn't look specifically at the impact of discharge summary quality on rehospitalization, Kind noted, "It makes a lot of sense to have a discharge summary completed on the day of discharge," she said. "It's pretty straightforward."

To help complete summaries in a timelier manner, the use of a nurse practitioner (NP) on the care team can improve the discharge process, according to a study in this month's Journal of Hospital Medicine. Although NP utilization didn't affect patient readmissions, NP use resulted in more completed discharge summaries within 24 hours (67 percent of the time, compared to 47 percent without an NP).

To learn more:
- read the news brief from the University of Wisconsin-Madison
- read the McKnight's Long-term Care & Assisted Living article
- here's the study abstract on NPs and the discharge process

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