Automated Versus Conventional Hospital Discharge Summaries and Prescriptions

Unity Health Toronto

Status: Completed

Conditions: Continuity of Patient Care; Medical Records Systems, Computerized; Hospital Information Systems; Patient Discharge

Treatments: Other: Electronic discharge summary system

Study type: Interventional

Funder types: Other

Identifiers

NCT00670865

07-364

Details and patient eligibility

About

The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.

Full description

For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care.

Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community.

We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.

Enrollment: 209 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Hospitalization on General Internal Medicine ward at St. Michael's Hospital

Exclusion criteria

• Transfer to another service
• Death during admission
• Remains in hospital past dates specified in study protocol

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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209 participants in 2 patient groups

eDischarge

Experimental group

Description:

The eDischarge arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use the electronic discharge summary program.

Treatment:

Other: Electronic discharge summary system

Traditional

No Intervention group

Description:

The traditional arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use "traditional," dictated discharge summaries.