The Quality of Electronic Discharge Summaries for Post-Discharge Care: Hospital Panel Assessment and IT to Support Improvement
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Mehnaz Adnan National Institute for Health Innovation, University of Auckland (3/11/10, Civic 2, 1.30)
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The Quality of Electronic Discharge Summaries for Post-Discharge Care: Hospital Panel Assessment and IT to Support Improvement
- 1. The Quality of Electronic Discharge Summaries for Post-Discharge Care: Hospital Panel Assessment and IT to Support Improvement MehnazAdnan With: Jim Warren, Martin Orr
- 2. Overview Objectives Discharge summaries Methods Findings Information Technology based remediation plan
- 3. Objectives Panel assessment of quality of Electronic Discharge Summaries(EDS) information for supporting post-discharge care Improvement of the EDS information quality using Information Technology
- 4. Discharge Summary Synopsis of patient condition Communicates post-discharge framework of care In Auckland: Transmitted via HL7 messages Hard copy to patient on discharge
- 6. Collected 200 de-identified hard copies of Electronic Discharge Summaries (EDS)
- 8. Two senior hospital specialists
- 9. One experienced specialist clinical coder
- 10. Questionnaire
- 13. EDS Analyses Questionnaire - Information Quality Information optimal to support ongoing management of the patient in General Practice? Provides adequate information to the patient about his/her ongoing care?
- 14. Findings: Assessment of Quality by EDS Sections 20% 30% 45% 42%
- 17. Information hard to access
- 18. Information written in other section
- 19. Poor formatting
- 20. Incomplete follow up advice
- 23. Information is written in other section
- 25. Unclear goals
- 26. Incorrect, incomplete and missing advice
- 27. Information written in other section
- 29. Brief or incomplete advice
- 32. Assessment of Relevancy- Proportion of Importance per EDS Section
- 34. Insufficient follow up information for GP
- 36. Writing Support in EDS High Risk Medications Recommended Auto Text Critique
- 37. Readability Support in EDS
- 39. Information technology can assist in improving quality of information in EDSs
- 42. Contact Mehnaz Adnanmadn002@aucklanduni.ac.nz For this presentation and others from HINZ please go to the hive
Notas del editor
- Questionnaire goal is to measure the quality and relevancy of written information in the items identified by previous studies to be important for continual management of the patient [1, 2, 21] .
- All summaries were evaluated for the quality of information using yes/no options in the questions for the following key items in EDS with a comment.
- indicate how important you think each entry is with respect to the needs of a GP viewing the summary for purposes of ongoing management of the patient. ORANGE for “most important” items which must be available directly in the top-level summaryGREEN for “important” items which should be accessible with one mouse click from the top-level summary.BLUE for “least important” items which would be better excluded from the discharge summary report.
- panel members were asked to code the reports using orange, blue and green highlighters.orange -> ‘most important’ green -> ‘important’blue -> ‘least important’
- We have improved our hyperlinking capability to providing linking to one topically relevant page instead of a list of pages returned by MedlinePlus. Currently we are exploring the provision of semantic descriptions for the abbreviations in Discharge Summaries text. Planning on conducting a user feed back to determine the efficacy of such a system is currently under way.