Key result
A quality improvement initiative utilizing provider education and EHR optimization increased the completion of three essential discharge elements from 45% to 73%.
Why the study?
Many discharge summaries fail to meet consensus standards, with local gaps identified in documenting discharge diagnosis, medications, and follow-up appointments.
Do Plan-Do-Study-Act cycles improve the completion of essential discharge documentation elements in patients discharged from the general pediatrics service?
Do Plan-Do-Study-Act cycles improve the completion of essential discharge documentation elements in patients discharged from the general pediatrics service?
Absolute Event Rate: 73% vs 45%
A quality improvement initiative utilizing provider education and EHR optimization significantly improved the completeness of pediatric discharge summaries.
May support local QI for pediatric discharge documentation; leaves open generalizability and sustainability across centers.
Introduction: Accurate discharge documentation is critical to ensuring a safe and effective transition of care following hospitalization, yet many discharge summaries do not meet consensus standards for content. A local needs assessment demonstrated gaps in documentation of 3 essential elements: discharge diagnosis, discharge medications, and follow-up appointments. This study aimed to increase the completion of three discharge elements from a baseline of 45% by 20 percentage points over 16 months for patients discharged from the general pediatrics service. Methods: Ten discharge summaries were randomly selected and analyzed during each successive 2-week time period. Plan-Do-Study-Act cycles aimed to improve provider knowledge of essential discharge summary content, clarify communication during rounds, and create electronic health record shortcuts and quick-reference tools. Results: The percentage of discharge summaries containing all 3 required elements increased from 45% to 73%. Specifically, documentation increased for discharge diagnosis (65%-87%), discharge medications (71%-90%), and follow-up appointments (88%-93%). There was no significant delay in discharge summary completion. Conclusions: Discharge summaries are meaningfully and sustainably improved through provider education, workflows for clear communication, and electronic health record optimization.
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Banker et al. (2022) studied General pediatrics discharge. Quality improvement initiative (PDSA cycles) vs. Baseline was evaluated on Discharge summaries containing all 3 required elements (discharge diagnosis, medications, and follow-up appointments). A quality improvement initiative utilizing provider education and EHR optimization increased the completion of three essential discharge elements from 45% to 73%.
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