Information transfer and the hospital discharge summary: National primary care provider perspectives of challenges and opportunities.
Open accessAbstract
PURPOSE: The hospital discharge summary (HDS) serves as a critical method of patient information transfer between hospitalist and primary care provider (PCP). This study was designed to increase our understanding of PCP preferences for, and perceived deficiencies in, the discharge summary. METHODS: We designed a mail survey that was sent to a random sample of 800 American Academy of Family Physicians members nationally. The survey response rate was 59%. We analyzed the availability of summaries at hospital followup, whether all desired information was contained in the summary and whether certain specific items were completed. Provider subgroup analysis was performed. RESULTS: < .0001). Providers also described significant content deficits: 26.5% of providers noted the summary contained all information needed 0% to 40% of the time, 48.5% of providers noted this 41% to 80% of the time and only 25% >80% of the time. Specific summary items considered "very important" by providers included medication list (94% of respondents), diagnosis list (89%), and treatment provided (87%). CONCLUSIONS: Opportunities remain in timely delivery of a complete HDS to the PCP. Further multifaceted practice redesign should be directed at optimizing this critical information transfer tool, potentially encompassing electronic medical record utilization and specific training for clinicians preparing summaries. Initial efforts should focus on ensuring availability of a complete summary (containing items deemed important by PCPs including medication list, diagnosis list, and treatment provided) at the posthospital follow-up visit.
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Medication reconciliation may help reduce hospital readmission.
“Medication reconciliation has been associated with fewer medication errors (598, 612) and may help reduce hospital readmission (613, 614).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [614]
The Discussion says complete, available hospital discharge summaries have been shown to reduce readmission risk, and the Results identify a medication list with changes as important summary content. But the paper does not say that medication reconciliation itself may reduce readmissions; a medication list in a discharge summary is not the same intervention. (LLM, conf=0.78)
Experimental — accuracy not yet measuredPrevious guidance was based on two small, blinded crossover RCTs that compared equimolar saline versus sodium bicarbonate in patients with lactic acidosis and failed to reveal any difference in hemodynamic variables or vasopressor requirements.
“The previous guidance was based on two small, blinded crossover RCTs that compared equimolar saline vs sodium bicarbonate in patients with lactic acidosis and failed to reveal any difference in hemodynamic variables or vasopressor requirements (526, 527).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [526]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredKey information from hospitalisation is often missing on hospital discharge documentation.
“Key information from hospitalisation is often missing on hospital discharge documentation [615–618].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [617]
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
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- Authors
- Robelia, P. M., Kashiwagi, D. T., Jenkins, S. M., Newman, J. S., & Sorita, A.
- Affiliations
- Mayo Clinic (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2017-11
- Volume
- 30
- Issue
- 6
- Pages
- 758-765
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W2770750122
- Semantic Scholar
- 0485d47cfb9b1a0cbc52c704dcc5383dcf2f645b
- Cited by
- 56
- References
- 16
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 6 · 2023: 4 · 2022: 4 · 2021: 10 · 2020: 7 · 2019: 2 · 2018: 4 · 2017: 2
- FWCI
- 5.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- discharge summaries, patient information transfer, primary care providers, medication lists, electronic health records, general practitioners
- MeSH terms
- Attitude of Health Personnel, Communication, Continuity of Patient Care, Humans, Interprofessional Relations, Patient Discharge, Physicians, Family, Time Factors, Hospitalists, Electronic Health Records, Self Report, Physicians, Primary Care, Health Information Exchange
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