A Discharge Summary is a report containing a description of a patient's hospital stay, diagnoses, interventions performed and recommended next steps. Discharge Summaries accompany patients after discharge from hospital and are written for care providers who will provide follow-up care.
At UHN, a Discharge Summary is completed for each patient admitted to an inpatient unit bed under a physician's admission order.
Each year, over 35,000 patients who were admitted and had care in the hospital are discharged from UHN, and over 46,000 copies of their Discharge Summaries are provided to their family physicians and referring providers.
Knowing that the Discharge Summary is a critical step in a patient's journey, UHN actively engaged patients and primary care, to deliver on its primary value – the needs of patients come first – and drive sustainable quality improvement for patients receiving care across 51 inpatient units. The Quality Improvement Plan (QIP) Discharge Summary Program has also resulted in a 76% increase in timely Discharge Summary completion and a 122% increase in timely delivery.
Currently, Discharge Summaries are also available to patients through the myUHN Patient Portal. For the first time, patients are also able to access their own information and able to share it with whomever they choose.
The program engaged three Patient Partners through the development of UHN's new Discharge Summary application. This collaboration allowed for electronic completion of Discharge Summaries and auto-generation of discharge medication documentation. The Patient Partners involved brought perspectives from all ages, various lived experiences with disease, and both short and long inpatient visits at UHN.
Prescribers and pharmacists participating in the pilot implementation of UHN's new electronic Discharge Summary application also consulted with patients they provided care for, to ensure continuous feedback cycles.
"Along with the other two Patient Partners, my role was to help design the prescription, the medication schedule, the pharmacy letter, and the follow-up instructions section of the Discharge Summary, and to review the changes to ensure that they would benefit future patients….I do believe and trust that this improved Discharge Summary process will greatly reduce medication-related errors, re-hospitalization, and other adverse events," said Millie Dolanjski, Patient Partner.
Clarity now provided in Discharge Summary follow-up instructions ensures a thorough patient and primary care provider understanding of the status of appointments and referrals required for follow-up care.
UHN's new electronic Discharge Summary application allows clinicians to customize patient medication and discharge information based on a patient's preferences, and ensure standardized instructional content to improve patient safety during their transition to primary care – including auto-generating two separate prescriptions, patient medication schedules and a wallet card medication summary.
The likelihood of adverse medication-related events and medication errors post-discharge is now reduced due to clearly marked medication purpose, status, dosage, and frequency information on patient copies of discharge medication documentation.
94% of UHN inpatients now have a timely Discharge Summary completed, a significant improvement from 50% back in 2014.
89% of UHN Discharge Summaries are auto-faxed to primary care providers within 48 hours of completion, a significant improvement from 40% back in 2014. This greatly helps to reduce the likelihood of patient readmissions and to ensure appropriate follow-up care within seven days of discharge from UHN when needed.