Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York, USA.
J Hosp Med. 2011 Jan;6(1):28-32. doi: 10.1002/jhm.831.
Discharge summaries (DS) communicate important clinical information from inpatient to outpatient settings. Previous studies noted increased adverse events and rehospitalization due to poor DS quality. We postulated that an audit and feedback intervention of DS completed by geriatric medicine fellows would improve the completeness of their summaries. We conducted a preintervention post intervention study. In phase 1 (AUDIT #1 and FEEDBACK) we scored all DS (n = 89) completed by first year fellows between July 2006 to December 2006 using a 21-item checklist. Individual performance scores were reviewed with each fellow in 30-minute feedback sessions. In phase 2 (AUDIT #2) we scored all DS (n = 79) completed after the first phase between February 2007 to July 2007 using the same checklist. Data were analyzed using generalized estimating equations. Fellows were more likely to complete all required DS data after feedback when compared with prior to feedback (91% vs. 71%, P < 0.001). Feedback was also associated with improved admission (93% vs. 70%, P < 0.001), duration of hospitalization (93% vs 78%, P < 0.001), discharge planning (93% vs. 18%, P < 0.02) and postdischarge care (83% vs. 57%., P < 0.001) section-specific information. In conclusion, audit and feedback sessions were associated with better DS completeness in areas of particular importance to geriatric care.
出院小结（DS）将重要的临床信息从住院病房传递到门诊环境。先前的研究指出，由于 DS 质量差，不良事件和再入院的发生率增加。我们推测，由老年医学研究员完成的 DS 审核和反馈干预措施将提高其摘要的完整性。我们进行了一项预干预后干预研究。在第 1 阶段（审核 #1 和反馈）中，我们使用 21 项检查表对 2006 年 7 月至 2006 年 12 月期间由第一年研究员完成的所有 DS（n = 89）进行评分。在 30 分钟的反馈会议中，我们与每位研究员一起审查了个人表现评分。在第 2 阶段（审核 #2）中，我们使用相同的检查表对 2007 年 2 月至 2007 年 7 月第一阶段之后完成的所有 DS（n = 79）进行评分。使用广义估计方程分析数据。与反馈前相比，研究员在反馈后更有可能完成所有必需的 DS 数据（91%比 71%，P <0.001）。反馈还与改善入院（93%比 70%，P <0.001）、住院时间（93%比 78%，P <0.001）、出院计划（93%比 18%，P <0.02）和出院后护理（83%比 57%，P <0.001）部分特定信息相关。总之，审核和反馈会议与老年护理特别重要的 DS 完整性方面的改善相关。
