Ger 12- Deficits in Communication Flashcards
What is the most common method for documenting a patients diagnostic findings, hospital management, and arrangements for post discharge follow-up?
Discharge summary
JCAHO requires discharge summaries to be completed within how long after discharge?
within 30 days
What are the 3 ways you can improve communication between hospital and outpatient setting?
Make them digital
Change the mode of delivery
Change the format of the document
Utilizing health information technology allows quick extraction of information to a set format that cna be reviewed by what 2 people?
Physicians
The pt
The use of computer generated summaries (with a template) over handwritten ones showed large improvements under what study?
Van Walraven
Lissauer et al and Janik et all foudn that the ommision rate for what thing decreased with computer-generated studies?
Essential information
What % of PCPs prefer computer-generated formats?
70%
To improve communication, who can be given a copy of the most pertinent date to a newly discharge pt?
The patient
Sandler and Mitchell foudn that hand delivery from pt to doctor decreased the median time to receipt from 4 days to what?
1 day
What was the only intervention study to evaluate the impact of their intervention of clinical outcomes?
Marks et al
Marks et al used pts with asthma and employed what 3 things to get higher rating by the PCP of overall being a part of the discharge process?
Telephone call to PCP
A scheduled follow-up appt
Educational booklets
What % of PCP’s report being involved int eh discussions about discharge?
3%
What % of PCPs report ALWAYS being notified about discharges?
17-20%
What are the 2 main form of communication at discharge?
Letters (handwritten narratives)
Summaries (dictations)
Which form of communication (letters or summaries) reaches the PCP faster?
Letter
True or False: PCP’s were more likely to receive information if the pts medications were changed during the hospitalization.
True
What % of the time was the ID of the responsible physician missing from the discharge summary?
25%
What % of the time was the main Dx missing from the discharge summary?
10.5%
What % of the time were diagnostic test results missing from the discharge summary?
38%
What % of the time were discharge medications missing from the discharge summary?
21%
What % of the time were followup plans missing from the discharge summary?
14%
What were the 2 contributors that caused the highest rates of missing information from a discharge summary?
Tests were pending at discharge (65%)
Counseling provided to the pts or families (91%)
What % of pts were being treated by their PCP befor ethe doctor had received their discharge letter?
16-53%
What % of pts were being treated by their PCP befor ethe doctor had received their discharge summary?
66-88%
If pts are getting treated before the PCP gets the discharge summary/letter, what is the main source of information about the hospitalization?
The patient
And you know they’re dumb lol
PCP’s were happiest when they received their discharge info within what time?
1 week
What % of test results (in a study) were pending on the day of discharge?
41%
Pending test results when a pt is discharged is bad, because what would happen if an abnormal result was obtained?
They’d need immediate attention but they already got kicked outta the hospital
What % of hospital physicians and PCPs are unaware of abnormal results after discharge?
60%
Had the docs known about the abnormal test result after discharge, how many would change the diagnosis or treatment?
1-2%
The growing # of specialties requires what change to happen along side it?
COMMUNICATION
