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关于医疗出院小结对患者安全风险的系统文献综述与叙述性综合分析

A systematic literature review and narrative synthesis on the risks of medical discharge letters for patients' safety.

作者信息

Schwarz Christine Maria, Hoffmann Magdalena, Schwarz Petra, Kamolz Lars-Peter, Brunner Gernot, Sendlhofer Gerald

机构信息

Research Unit for Safety in Health, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.

Executive Department for Quality and Risk Management, University Hospital Graz, Auenbruggerplatz 1/3, 8036, Graz, Austria.

出版信息

BMC Health Serv Res. 2019 Mar 12;19(1):158. doi: 10.1186/s12913-019-3989-1.

Abstract

BACKGROUND

The medical discharge letter is an important communication tool between hospitals and other healthcare providers. Despite its high status, it often does not meet the desired requirements in everyday clinical practice. Occurring risks create barriers for patients and doctors. This present review summarizes risks of the medical discharge letter.

METHODS

The research question was answered with a systematic literature research and results were summarized narratively. A literature search in the databases PubMed and Cochrane Library for Studies between January 2008 and May 2018 was performed. Two authors reviewed the full texts of potentially relevant studies to determine eligibility for inclusion. Literature on possible risks associated with the medical discharge letter was discussed.

RESULTS

In total, 29 studies were included in this review. The major identified risk factors are the delayed sending of the discharge letter to doctors for further treatments, unintelligible (not patient-centered) medical discharge letters, low quality of the discharge letter, and lack of information as well as absence of training in writing medical discharge letters during medical education.

CONCLUSIONS

Multiple risks factors are associated with the medical discharge letter. There is a need for further research to improve the quality of the medical discharge letter to minimize risks and increase patients' safety.

摘要

背景

出院小结是医院与其他医疗服务提供者之间重要的沟通工具。尽管其地位重要,但在日常临床实践中,它往往无法满足预期要求。出现的风险给患者和医生带来了障碍。本综述总结了出院小结的风险。

方法

通过系统的文献研究回答研究问题,并对结果进行叙述性总结。在PubMed和Cochrane图书馆数据库中检索了2008年1月至2018年5月期间的研究。两位作者对潜在相关研究的全文进行了审查,以确定是否符合纳入标准。讨论了与出院小结相关的可能风险的文献。

结果

本综述共纳入29项研究。确定的主要风险因素包括出院小结发送给医生进行进一步治疗的延迟、难以理解(非以患者为中心)的出院小结、出院小结质量低下、信息缺乏以及医学教育期间缺乏出院小结书写培训。

结论

出院小结存在多种风险因素。需要进一步研究以提高出院小结的质量,将风险降至最低并提高患者安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8453/6417275/7943b8913e4a/12913_2019_3989_Fig1_HTML.jpg

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