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- Title
Medication reconciliation and discharge communication from hospital to general practice: a quantitative analysis.
- Authors
Gusmeroli, Melinda; Perks, Stephen; Bates, Nicole
- Abstract
Background: The aim of this study was to assess the quality of effective discharge communication to primary practice from a hospital that uses ieMR (integrated electronic Medical Record), a complete electronic prescribing/medical record platform. Methods: A retrospective quantitative analysis of 232 discharge encounters from a major tertiary hospital assessed the discharge summary quality; timeliness, completeness and medication information. Results: Median time to discharge summary was 1 day. 22.0% of discharge summaries were incomplete at 30 days post discharge and 44.5% of discharge summaries were incomplete at 30 days post discharge if discharged on a weekend compared to weekday (P -value = 0.001). Rates of medication reconciliation were completed at approximately 35% at each point of the patient stay and 56.9% of patients had a GP discharge summary listing discharge medications. However, if certain progressive steps were completed (i.e. Home Medications recorded in ieMR, Discharge Reconciliation in ieMR, and Patient Discharge Medication Record in eLMs (Enterprise-wide Liaison Medication System)), then, the 'Medications on Discharge' was significantly more likely to be present in the discharge summary, at rates of 70.1%, 85.9%, and 98.6% respectively (P -value = 0.007, <0.001, <0.001). Conversely not doing these steps dropped rates of having medications listed in the discharge summary to 50.0%, 40.3% and 34.1% respectively. Conclusions: This study assessed current discharge summary quality since the introduction of electronic medical records. It demonstrated the significant value of correct use of electronic programs, including performing all crucial steps of reconciliation. Targeted interventions in future studies that rectify the shortfalls in discharge communication are warranted. Significant digital advances to hospital communication practices have occurred over the last 15 years, including technology-based methods to generate discharge summaries. An audit of discharge communication from a major tertiary hospital utilising a complete electronic prescribing/records platform showed there are large deficits in the quality and timing of information going to primary care after discharge. Incorrect use of electronic platforms can have major negative effects on the quality of discharge communication. Workflow processes must put a higher regard to correctly working in-line with the way these programs are designed.
- Subjects
HOSPITALS; FAMILY medicine; RETROSPECTIVE studies; PHARMACY management; QUALITATIVE research; MEDICATION therapy management; PEARSON correlation (Statistics); COMMUNICATION; QUALITY assurance; DESCRIPTIVE statistics; CHI-squared test; MEDICATION reconciliation; ELECTRONIC health records; DATA analysis software; ODDS ratio; DISCHARGE planning; PATIENT discharge instructions
- Publication
Australian Journal of Primary Health, 2023, Vol 29, Issue 6, p679
- ISSN
1448-7527
- Publication type
Article
- DOI
10.1071/PY22232