Journal of hospital medicine : an official publication of the Society of Hospital Medicine
-
Computerized physician handoff tools (CHTs) are designed to allow distributed access and synchronous archiving of patient information via Internet protocols. However, their impact on the quality of physician handoff, patient care, and physician work efficiency have not been extensively analyzed. ⋯ The evidence that CHTs improve physician handoff and quality of hospitalized patient care is limited. CHT may improve the efficiency of physician work, reduce adverse events, and increase the completeness of physician handoffs. However, further evaluation using rigorous study designs is needed.
-
Discharge from hospital can be a vulnerable period for patients. Multifaceted "discharge bundles" facilitate care transitions and possibly decrease adverse outcomes. We describe a structured approach to discharge planning, starting from admission and proceeding through discharge, using a standardized checklist of tasks to be performed for each hospitalization day. ⋯ The Checklist of Safe Discharge Practices for Hospital Patients summarizes the sequence of events that need to be completed throughout a typical hospitalization. Standardizing discharge planning and initiating processes early on in a patient's hospital stay may ensure a safe transition home.
-
Little is known about the contribution of psychiatric illness to medical 30-day readmission risk. ⋯ Our data suggest that patients treated during a hospitalization for depression and for schizophrenia are at higher risk for potentially avoidable 30-day readmissions, whereas those prescribed more psychiatric medications as outpatients are at increased risk for all-cause readmissions. These populations may represent fruitful targets for interventions to reduce readmission risk.
-
Multicenter Study
Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization.
Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown. ⋯ Participation in Project BOOST appeared to be associated with a decrease in readmission rates.
-
Discharge summaries are essential for safe transitions from hospital to home. ⋯ Discharge summary quality is inadequate in many domains. This may explain why individual aspects of summary quality such as timeliness or content have not been associated with improved patient outcomes. However, improving discharge summary timeliness may also improve content and transmission.