Is email an effective method for hospital discharge communication? A randomized controlled trial to examine delivery of computer-generated discharge summaries by email, fax, post and patient hand delivery
Section snippets
Background
Timely and accurate discharge summaries play a critical role in the continuity of patient care between hospitals and primary care physicians or general practitioners (GPs) in the community. Ideally, hospital discharge summaries should communicate important medical information including presentation and diagnosis, investigation results, management changes, discharge medications and any further actions the GP is encouraged to pursue [1]. Poor discharge communication imposes a considerable burden
Setting
The study was undertaken within the acute aged care ward of a 350-bed metropolitan teaching hospital attached to the University of New South Wales in Sydney, Australia. Database based electronic discharge summaries are regularly generated by a multidisciplinary team, including doctors, nurses and allied health professionals, for all patients discharged from the ward. An electronic medication management system is also used to maintain medication charts for all patients. The electronic discharge
Audit and study period
Sixty-three discharge summaries were available for the pre-study audit over one month. In 14 cases GPs were not contactable. The receipt rate of the 49 discharge summaries that were available for follow-up was 55.1% (n = 27).
The study period included discharges of 196 patients admitted to the aged care ward over 10 weeks. Twenty-eight (28) patients were excluded because they were not admitted under a geriatrician (19) or were transferred to another ward prior to discharge (9). The remaining 168
Main findings and implications
We have compared four methods for delivering computer-generated hospital discharge summaries to general practice. While the accuracy of computer-generated discharge summaries has been previously investigated, few studies have examined the timeliness of specific methods for delivery of discharge communication. This is the first study we are aware of that compares the effectiveness of email, fax, post and patient hand delivery. We found that delivery via email and fax was comparable and
Conclusion
The method of discharge communication is an important factor in determining the timely delivery of a hospital discharge summary to general practice. Fax and email are the most effective modes for sending discharge summaries. Although fax is still widely accepted, email has the potential to overcome many of the shortcomings of fax and provide a secure and effective means of communication with GPs. Up-to-date GP contact details will likely improve rates of discharge summary receipt leading to
Acknowledgements
We thank the hospital and general practice staff who gave their time to participate in this study.
The source of funding for this study was from the University of New South Wales. YC is enrolled in a medical course within this institution and the study was undertaken as part of their degree.
FM is supported by the Australian Research Council (LP0775532) and the University of New South Wales, Faculty of Medicine.
Contributions: YC and NB were responsible for identifying the research question;
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