Impact of Educational Intervention on Quality of Discharge Summaries
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 2
Abstract
ABSTRACT Introduction: Immaculate and timely communication among healthcare providers is crucial for continuity of care. Discharge summaries are commonly used for communication among different healthcare facilities. Deficiencies in discharge summaries may lead to various adversities and hamper optimal resource utilisation. In academic institutions, discharge summaries are prepared by junior doctors without formal training. Aim: To assess the effect of educational intervention in improving quality of discharge summaries. Materials and Methods: The present educational intervention study was conducted in Department of General Medicine of a tertiary care rural teaching hospital in Gujarat, India. A two-hour structured workshop for medicine residents was conducted in September 2013 by a senior consultant. Discharge summaries of patients admitted for more than 48 hours in Department of General Medicine in August 2013 and October 2013 were audited by trained consultants. Individual Feedback Form (IFF) for discharge summaries from Reviewing Effective and Accurate Documentation (READ) workshop was used for assessing the quality of discharge summaries. Descriptive statistics {mean±SD, frequency (%)} were used to depict pertinent characteristics of the data. Independent sample t-test was used to gauge the effect of the educational intervention in different domains assessed on five point Likert scale as well as for total score. Chi-square test was applied to assess the effect of the educational intervention on categorical variables. The analysis was performed using STATA (14.2). Results: A total of 18 residents participated in the study. Total 426 discharge summaries (223 and 203 from pre and post intervention periods respectively) were audited. The quality of discharge summaries improved significantly in the domains of history, physical examination, diagnostic data, hospital course and discharge plan as well as composite score (total score). The documentation quality of ‘basic elements’ as well as ‘overall impression’ also improved significantly. Despite these improvements, serious lapses in social and family history were observed. An informal discussion by the statistician revealed that most residents were positive about the experience but expressed concern about ‘lack of time’ and suggested automation as a feasible solution. Conclusion: The quality of discharge summaries was suboptimal before the educational intervention. Albeit retention of skills was not evaluated, the educational intervention improved the quality of discharge summaries.
Authors and Affiliations
Ajay Gajanan Phatak, Mahesh Mathew, Nikhil M Dave, Mihir Parekh, Himanshu V Pandya
Keywords
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- EP ID EP514088
- DOI 10.7860/JCDR/2018/30042.11188
- Views 48
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