Improvement of Timeliness of Inpatient Discharge Summary in an Inner-City Urban Community Hospital

Abstract

Background: Discharge summary (DS) plays a central role in transition of care between inpatient and outpatient settings and is a patient safety issue [1, 2]. Baseline data showed that 80% by cycle 7. A steady improvement in the first 3 cycles was followed by a drop in completion rates between cycle 3 and cycle 7, reaching a nadir of 42%. This was attributed to lack of adequate training and assignment of responsibility, and interventions 3 through 5 were applied. Last three cycles showed completion rates >80%. Discussion: Sustained improvement in DS timeliness was evident as illustrated in 'Figure 1'. However, there is still a significant portion of DS which are delayed. Potential causes include weekend coverage by non-floor residents and poor-quality DS that requires modification before attending can sign off the document. Our future PDSA cycles will reinforce current interventions and focus on improving quality of DS using quality report cards and feedback from primary providers.

Keywords

• discharge summary
• timeliness
• quality improvement