Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
Abstract Background Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-017-2579-3 |
| _version_ | 1819231927022911488 |
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| author | Rajnikant L. Mehta Bryn Baxendale Katie Roth Victoria Caswell Ivan Le Jeune Jack Hawkins Haya Zedan Anthony J. Avery |
| author_facet | Rajnikant L. Mehta Bryn Baxendale Katie Roth Victoria Caswell Ivan Le Jeune Jack Hawkins Haya Zedan Anthony J. Avery |
| author_sort | Rajnikant L. Mehta |
| collection | DOAJ |
| description | Abstract Background Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. Methods A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. Results The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0% to 93.0% (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). Conclusion The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication. |
| first_indexed | 2024-12-23T11:52:44Z |
| format | Article |
| id | doaj.art-b12c68197c3e4c2694bc67af774c2573 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-23T11:52:44Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-b12c68197c3e4c2694bc67af774c25732022-12-21T17:48:10ZengBMCBMC Health Services Research1472-69632017-09-0117111010.1186/s12913-017-2579-3Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after studyRajnikant L. Mehta0Bryn Baxendale1Katie Roth2Victoria Caswell3Ivan Le Jeune4Jack Hawkins5Haya Zedan6Anthony J. Avery7School of Medicine, University of Nottingham, Queens Medical CentreNottingham University Hospitals NHS Trust, Queens Medical CentreSchool of Medicine, University of Nottingham, Queens Medical CentreSchool of Medicine, University of Nottingham, Queens Medical CentreNottingham University Hospitals NHS Trust, Queens Medical CentreUniversity Hospitals Leicester, Emergency Care Intensive Support TeamDepartment of Health Informatics, College of Health Sciences, Saudi Electronic UniversitySchool of Medicine, University of Nottingham, Queens Medical CentreAbstract Background Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. Methods A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. Results The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0% to 93.0% (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). Conclusion The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication.http://link.springer.com/article/10.1186/s12913-017-2579-3Discharge summariesGold standard auditing toolNew electronic discharge systemCompleteness |
| spellingShingle | Rajnikant L. Mehta Bryn Baxendale Katie Roth Victoria Caswell Ivan Le Jeune Jack Hawkins Haya Zedan Anthony J. Avery Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study BMC Health Services Research Discharge summaries Gold standard auditing tool New electronic discharge system Completeness |
| title | Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study |
| title_full | Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study |
| title_fullStr | Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study |
| title_full_unstemmed | Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study |
| title_short | Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study |
| title_sort | assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication a before and after study |
| topic | Discharge summaries Gold standard auditing tool New electronic discharge system Completeness |
| url | http://link.springer.com/article/10.1186/s12913-017-2579-3 |
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