Table 1.
Study | Study design | Study setting | Targeted TPAD type | Intervention | Unit of analysis | Primary outcome(s) | Outcome type | TPAD outcome |
---|---|---|---|---|---|---|---|---|
Balaban12 | RCT | Medicine ward | Not described | Discharge summary template that includes TPADS, electronic transfer of discharge summary to primary care RN, RN discharge facilitator, PCP feedback on post-discharge care plan | Patient | 1. No outpatient appointment within 21 days with either an MD or NP at the patient’s primary care site or with a relevant specialist 2. Readmission, for any reason, within 31 days to any of three study hospitals 3. Emergency department visits within 31 days for a problem related to the original admission in any of the 3 CHA hospitals 4. Failure to complete an outpatient workup recommended by a hospital doctor |
Patient, process | No |
Dalal13 | RCT | Medicine ward | Microbiology, radiology, biochemistry, hematology | Automated email alerts to discharging physician of finalized test results | Physician | Self-reported awareness of TPAD results by discharging physician | Process | Yes |
Dinescu14 | POS | Medicine ward | Not described | Audit of discharge summary quality (including TPADs) and feedback loop | Patient | 1. Admission composite score 2. Hospital course composite score 3. Discharge planning composite score 4. Post-discharge care composite score (including test results to follow-up) |
Process | Yes |
El-Kareh15 | RCT | Medicine ward | Microbiology | Automated email alerts to discharging physician of finalized microbiology test results of possibly inadequately infections | TPAD | Documentation in the patient’s outpatient electronic chart of documentation of follow-up action within 3 days of the post-discharge microbiology result finalizing (note contains acknowledgement of the result, follow-up with the patient, or new antibiotic prescription) | Process | Yes |
Graumlich16 | RCT | Medicine ward | Not described | Electronic discharge template prompts discharging physician to enter TPADs | Patient | Proportion of patients readmitted at least once within 6 months after the index hospitalization | Patient | No |
Kantor17 | POS | Medicine ward | Microbiology, hematology, biochemistry, pathology | Electronic discharge application prompts to include TPADs from automatically generated list | TPAD, discharge summary | 1. Proportion of pending studies communicated in discharge summary 2. Proportion of discharge summaries communicated all pending studies |
Process | Yes |
O’Leary18 | POS | Medicine ward | Not described | Electronic discharge with template (including TPADs), automated distribution to PCP | DSCS, TPAD | 1. Discharge Summary Completeness Score (DSCS) (out of 100) 2. Pending tests documented in discharge summary |
Process | Yes |
Cadwallader19 | POS | Medicine ward | Not described | Electronic discharge template requires TPADs manual entry | Discharge summary | Percentage of tests with pending results that were documented in the discharge summaries | Process | Yes |
Jack20 | RCT | Medicine ward | Not described | Discharge template includes TPADs, discharge planner to arrange PCP follow-up | Patient | Total number of emergency department visits and readmissions per participant within 30 days of the index discharge | Patient | No |
*Abbreviations: CHA, Cambridge Health Alliance; DSCS, Discharge Summary Completeness Score; MD, medical doctor; NP, nurse practitioner; PCP, primary care physician; POS, prospective observational study; RCT, randomized controlled trial; RN, registered nurse; TPAD, test pending at discharge