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Canadian Family Physician logoLink to Canadian Family Physician
. 2002 Apr;48:737–742.

Dissemination of discharge summaries. Not reaching follow-up physicians.

Carl van Walraven 1, Ratika Seth 1, Andreas Laupacis 1
PMCID: PMC2214034  PMID: 12046369

Abstract

OBJECTIVE: To discover how often hospital discharge summaries were available to physicians seeing patients for follow-up visits after hospitalization. DESIGN: Cohort study. SETTING: Teaching hospital in Ottawa, Ont. PARTICIPANTS: We studied 792 patients discharged from an internal medicine service after treatment for acute illness. We determined when and by which physician each patient was seen during the first 6 months after discharge. We also determined the date each patient's discharge summary was printed and the physicians to whom it was sent. We confirmed that summaries were received by means of a survey or by telephoning physicians' offices. Patients were observed for 6 months or until they were readmitted to hospital. MAIN OUTCOME MEASURES: Proportion of follow-up visits to physicians for which discharge summaries were available. RESULTS: During the observation period, patients made 6619 visits (median six per patient, interquartile range [IQR] 2 to 9) to 914 different physicians (median three per patient, IQR 2 to 4). Discharge summaries were available for only 996 (15%) visits. Summaries were available for only 65 initial visits (8.2%); no summaries were available for any visit for 542 (68.4%) patients. Summaries were most commonly unavailable because they were not generated in time for follow-up visits (20.0%) or were not sent to follow-up physicians (50.8%). CONCLUSION: At our institution, discharge summaries often did not get to physicians seeing patients after discharge from hospital.

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Selected References

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  1. Bolton P., Mira M., Kennedy P., Lahra M. M. The quality of communication between hospitals and general practitioners: an assessment. J Qual Clin Pract. 1998 Dec;18(4):241–247. doi: 10.1046/j.1440-1762.1998.00281.x. [DOI] [PubMed] [Google Scholar]
  2. Branger P. J., van der Wouden J. C., Schudel B. R., Verboog E., Duisterhout J. S., van der Lei J., van Bemmel J. H. Electronic communication between providers of primary and secondary care. BMJ. 1992 Oct 31;305(6861):1068–1070. doi: 10.1136/bmj.305.6861.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Capen K. Findings of negligence followed communication lapses in BC aneurysm case. CMAJ. 1997 Jan 1;156(1):49–51. [PMC free article] [PubMed] [Google Scholar]
  4. Damian D., Tattersall M. H. Letters to patients: improving communication in cancer care. Lancet. 1991 Oct 12;338(8772):923–925. doi: 10.1016/0140-6736(91)91782-p. [DOI] [PubMed] [Google Scholar]
  5. Fair J. F. Hospital discharge and death communications. Br J Hosp Med. 1989 Jul;42(1):59–61. [PubMed] [Google Scholar]
  6. Gosbee J. Communication among health professionals. BMJ. 1998 Feb 28;316(7132):642–642. doi: 10.1136/bmj.316.7132.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Harding J. Study of discharge communications from hospital doctors to an inner London general practice. J R Coll Gen Pract. 1987 Nov;37(304):494–495. [PMC free article] [PubMed] [Google Scholar]
  8. Lindenauer P. K., Pantilat S. Z., Katz P. P., Wachter R. M. Hospitalists and the practice of inpatient medicine: results of a survey of the National Association of Inpatient Physicians. Ann Intern Med. 1999 Feb 16;130(4 Pt 2):343–349. doi: 10.7326/0003-4819-130-4-199902161-00003. [DOI] [PubMed] [Google Scholar]
  9. Lockwood E., McCallum F. M. Patients discharged from hospital: an aspect of communication in the Health Service. Health Bull (Edinb) 1970 Apr;28(2):75–80. [PubMed] [Google Scholar]
  10. Long A., Atkins J. B. Communications between general practitioners and consultants. Br Med J. 1974 Nov 23;4(5942):456–459. doi: 10.1136/bmj.4.5942.456. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mageean R. J. Study of "discharge communications" from hospital. Br Med J (Clin Res Ed) 1986 Nov 15;293(6557):1283–1284. doi: 10.1136/bmj.293.6557.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Manning R. T. Dictation of the discharge resumé: a forgotten link between the spoken and written word. J Gen Intern Med. 1989 Sep-Oct;4(5):453–456. doi: 10.1007/BF02599699. [DOI] [PubMed] [Google Scholar]
  13. Paterson J. M., Allega R. L. Improving communication between hospital and community physicians. Feasibility study of a handwritten, faxed hospital discharge summary. Discharge Summary Study Group. Can Fam Physician. 1999 Dec;45:2893–2899. [PMC free article] [PubMed] [Google Scholar]
  14. Penney T. M. Delayed communication between hospitals and general practitioners: where does the problem lie? BMJ. 1988 Jul 2;297(6640):28–29. doi: 10.1136/bmj.297.6640.28-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sandler D. A., Mitchell J. R. Interim discharge summaries: how are they best delivered to general practitioners? Br Med J (Clin Res Ed) 1987 Dec 12;295(6612):1523–1525. doi: 10.1136/bmj.295.6612.1523. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sox H. C. The hospitalist model: perspectives of the patient, the Internist, and internal medicine. Ann Intern Med. 1999 Feb 16;130(4 Pt 2):368–372. doi: 10.7326/0003-4819-130-4-199902161-00008. [DOI] [PubMed] [Google Scholar]
  17. Wachter R. M. An introduction to the hospitalist model. Ann Intern Med. 1999 Feb 16;130(4 Pt 2):338–342. doi: 10.7326/0003-4819-130-4-199902161-00002. [DOI] [PubMed] [Google Scholar]
  18. van Walraven C., Goel V., Austin P. Why are investigations not recommended by practice guidelines ordered at the periodic health examination? J Eval Clin Pract. 2000 May;6(2):215–224. doi: 10.1046/j.1365-2753.2000.00245.x. [DOI] [PubMed] [Google Scholar]
  19. van Walraven C., Laupacis A., Seth R., Wells G. Dictated versus database-generated discharge summaries: a randomized clinical trial. CMAJ. 1999 Feb 9;160(3):319–326. [PMC free article] [PubMed] [Google Scholar]
  20. van Walraven C., Rokosh E. What is necessary for high-quality discharge summaries? Am J Med Qual. 1999 Jul-Aug;14(4):160–169. doi: 10.1177/106286069901400403. [DOI] [PubMed] [Google Scholar]
  21. van Walraven C., Weinberg A. L. Quality assessment of a discharge summary system. CMAJ. 1995 May 1;152(9):1437–1442. [PMC free article] [PubMed] [Google Scholar]

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