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How Effectively Do Discharge Summaries Reduce Hospital Readmissions Risk?

January 16, 2015
by John DeGaspari
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Yale studies look at heart failure patients making the transition from hospital to home

Two studies from the Yale School of Medicine have determined that discharge summaries can help to reduce the risk of readmissions, but with some caveats. The findings have been published in the journal, Circulation: Cardiovascular Quality and Outcomes.

According to an report in Yale News, the researchers analyzed data from Telemonitoring to Improve Heart Failure Outcomes (Tele-HF), a large multicenter study of patients hospitalized with heart failure, which contained more than 1,500 discharge summaries from 46 hospitals across the country.

The lead author of one of the studies, Leora Horwitz, M.D., adjunct professor of internal medicine at Yale School of Medicine and director of the Center for Healthcare Innovation and Delivery Science at New York University Medical Center, says the medical community has not made full use of discharge summaries as a tool for transitions. She says discharge summaries need to do three things to make the transition from hospital to home safer: timeliness, be sent to the outside physician, and include useful information.

As noted in the Yale News story, Horwitz and her team were surprised by the results of the first study. They expected the summaries to be similar at all the hospitals they analyzed, but they found that hospitals varied widely in their performance. The quality of discharge summaries was insufficient in terms of timeliness, transmission, and content, even in the highest performing hospitals, and no hospital consistently produced high-quality summaries in all domains.

The focus of the second study, which used the same data from Tele-HF, looked at whether improving hospital practices regarding discharge summaries made a difference in hospital readmissions. It found that discharge summary quality was indeed associated with readmission risk, and that patients whose summaries included useful content or were sent to outside clinicians had lower readmission rates.




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