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The discharge summary is a vital tool for transferring information between the hospitalist and primary care physician, but it isn’t always given the priority it deserves. Furthermore, between 66% and 88% of discharge summaries were not sent to the outpatient provider in time for the follow-up visit, the study found. A structured, standard discharge summary form ensures that all the important information is included and allows the receiving physician to more quickly identify how to respond to the patient’s hospitalization, said Mark Williams, FACP, chief of the hospital medicine division at Chicago’s Northwestern Medical Center and co-author of the JAMA article. The Joint Commission mandates that discharge summaries contain certain components: reason for hospitalization, significant findings, procedures and treatment provided, patient’s discharge condition, patient and family instructions, and attending physician’s signature.
Experts advised keeping summaries short for easy readability— ideally no more than two pages long—and including information that is most relevant for the primary care physician. Most important to include are the reason for admission, medications (indicating new, changed, and discontinued), follow- up plans and appointments, outstanding issues for followup, and results of any tests or lab work pending at time of discharge, said Jeffrey Greenwald, MD, a hospitalist and director of the hospital medicine unit at Boston Medical Center.
Thomas Bodenheimer, FACP, an internist affiliated with the University of California, San Francisco, who has written about transitions in care, said that variability in discharge summaries and omission of important data occur not because physicians disagree on what needs inclusion but because hospitalists are busy and may not have time to adequately coordinate care with the primary care practice. At least one study has demonstrated a trend toward a decreased risk of readmission when the discharge summary arrives before the outpatient follow-up visit takes place.


Another solution to ensuring timely completion and delivery of discharge summaries is for the hospital to audit hospital records. Another solution to ensuring timely completion and delivery of discharge summaries is for the hospital to audit hospital records However, Dr.
In addition to directly sending the summary to the outpatient physician, all of the hospitalists interviewed for this article said their hospitals also give the discharged patient a copy of the discharge summary to hand-deliver to their physician.
Electronic health record systems also likely will speed both completion and transmission of the discharge summary as more hospitals go online.
Get news and information for hospitalists, covering the latest trends and issues in the field, delivered free.
ACP's MOC Navigator - A free ACP tool to help you understand the complexities of Maintenance of Certification. ACP MOC Resources - ACP offers a variety of recertification resources to help you earn both MOC points and CME credits through the same educational program. ACP offers different categories of membership depending on your career stage and professional status. Ensure you're board-exam ready with ACP's Board Prep Ace - a multifaceted, self-study program that prepares you to pass the ABIM Certification Exam in internal medicine. ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP.
Lymph nodes are small, bean-shaped structures in the body that are sometimes incorrectly called "glands." They are part of the lymphatic system, which carries lymph fluid, nutrients, and waste material between the body tissues and the bloodstream.
Hospitals and other health care organizations work to reduce medication errors by using technology, improving processes, zeroing in on errors . Too often, research suggests, summaries contain insufficient or unnecessary information and fail to reach the primary care physician in time for the patient’s follow-up visit, if they arrive at all. 28, 2007, Journal of the American Medical Association (JAMA), found that important data often were missing from discharge summaries.
For about 25% of patients, the outpatient physician did not receive the discharge summary at all. Yadav at Baystate—are helping their institutions develop templates for discharge summaries.


Also, a few health care groups, including the National Quality Forum (NQF) and the Society of Hospital Medicine (see sidebar), have proposed discharge checklists. Williams said, is that patients receive care until “literally the moment of discharge.” If the physician had already entered the summary before discharge, last-minute care would not be included.
However, independent physicians often do not have the same electronic data systems as hospitals, Dr.
The lymphatic system is part of the immune system, which is the body's defense system against disease. For example, if a person has a throat infection, the lymph nodes in the neck may swell and become tender.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. In the review of 73 studies, the primary diagnosis was omitted a median of 17.5% of the time, a list of medications at discharge did not appear in 21% of summaries, and pending test results were not included in 65%. He noted that sometimes primary care physicians are not even informed of their patient’s discharge. For instance, a hospital can allow hospitalists to discharge a patient only when they enter the summary. Jobs are posted about two weeks before print publication of Annals of Internal Medicine, ACP Internist, and ACP Hospitalist. A 2006 report from the Institute of Medicine of the National Academics says preventable medication errors harm . When they do, as is the case with many community physicians affiliated with Northwestern Medical Center, they may receive an email that their patient was discharged, Dr.



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