Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study

Background: Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate wh...

Full description

Bibliographic Details
Main Authors: Mehta, Rajnikant, Baxendale, Bryn, Roth, Katie, Caswell, Victoria, Le Jeune, Ivan, Hawkins, Jack, Zedan, Haya Saud, Avery, Anthony J.
Format: Article
Published: BIOMED 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/46578/
_version_ 1848797359543156736
author Mehta, Rajnikant
Baxendale, Bryn
Roth, Katie
Caswell, Victoria
Le Jeune, Ivan
Hawkins, Jack
Zedan, Haya Saud
Avery, Anthony J.
author_facet Mehta, Rajnikant
Baxendale, Bryn
Roth, Katie
Caswell, Victoria
Le Jeune, Ivan
Hawkins, Jack
Zedan, Haya Saud
Avery, Anthony J.
author_sort Mehta, Rajnikant
building Nottingham Research Data Repository
collection Online Access
description Background: Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. Methods: A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. Results: The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0% to 93.0% (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). Conclusion: The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication.
first_indexed 2025-11-14T20:02:37Z
format Article
id nottingham-46578
institution University of Nottingham Malaysia Campus
institution_category Local University
last_indexed 2025-11-14T20:02:37Z
publishDate 2017
publisher BIOMED
recordtype eprints
repository_type Digital Repository
spelling nottingham-465782020-05-04T19:04:29Z https://eprints.nottingham.ac.uk/46578/ Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study Mehta, Rajnikant Baxendale, Bryn Roth, Katie Caswell, Victoria Le Jeune, Ivan Hawkins, Jack Zedan, Haya Saud Avery, Anthony J. Background: Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England. Methods: A before and after longitudinal study design was used. Data were collected using the gold standard auditing tool from the Royal College of Physicians (RCP). This tool contains a checklist of 57 items grouped into seven categories, 28 of which are classified as mandatory by RCP. Percentage completeness (out of the 28 mandatory items) was considered to be the primary outcome measure. Data from 773 patients discharged directly from the acute medical unit over eight-week long time periods (four before and four after the change to the NewEDS) from August 2010 to May 2012 were extracted and evaluated. Results were summarised by effect size on completeness before and after changeover to NewEDS respectively. The primary outcome variable was represented with percentage of completeness score and a non-parametric technique was used to compare pre-NewEDS and post-NewEDS scores. Results: The changeover to the NewEDS resulted in an increased completeness of discharge summaries from 60.7% to 75.0% (p < 0.001) and the proportion of summaries created under 24 h from discharge increased significantly from 78.0% to 93.0% (p < 0.001). Furthermore, five of the seven grouped checklist categories also showed significant improvements in levels of completeness (p < 0.001), although there were reduced levels of completeness for three items (p < 0.001). Conclusion: The introduction of a NewEDS was associated with a significant improvement in the completeness and timeliness of hospital discharge communication. BIOMED 2017-09-05 Article PeerReviewed Mehta, Rajnikant, Baxendale, Bryn, Roth, Katie, Caswell, Victoria, Le Jeune, Ivan, Hawkins, Jack, Zedan, Haya Saud and Avery, Anthony J. (2017) Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study. BMC Health Services Research, 17 . 624/1-624/10. ISSN 1472-6963 Discharge summaries; Gold standard auditing tool; New electronic discharge system; Completeness https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2579-3 doi:10.1186/s12913-017-2579-3 doi:10.1186/s12913-017-2579-3
spellingShingle Discharge summaries; Gold standard auditing tool; New electronic discharge system; Completeness
Mehta, Rajnikant
Baxendale, Bryn
Roth, Katie
Caswell, Victoria
Le Jeune, Ivan
Hawkins, Jack
Zedan, Haya Saud
Avery, Anthony J.
Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title_full Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title_fullStr Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title_full_unstemmed Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title_short Assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
title_sort assessing the impact of the introduction of an electronic hospital discharge system on the completeness and timeliness of discharge communication: a before and after study
topic Discharge summaries; Gold standard auditing tool; New electronic discharge system; Completeness
url https://eprints.nottingham.ac.uk/46578/
https://eprints.nottingham.ac.uk/46578/
https://eprints.nottingham.ac.uk/46578/