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Elderly at risk in care transitions When discharge summaries are poorly transferred and used -a descriptive study

Caleres, Gabriella LU ; Bondesson, Åsa LU ; Midlöv, Patrik LU and Modig, Sara LU (2018) In BMC Health Services Research 18(1).
Abstract

BACKGROUND: Discharge summary with medication report effectively counteracts drug-related problems among elderly patients due to insufficient information transfer in care transitions. However, this requires optimal transfer and use of the discharge summaries. This study aimed to examine information transfer with discharge summaries from hospital to primary care.

METHODS: A descriptive study with data consisting of discharge summaries of 115 patients, 75 years or older, using five or more drugs, collected during one week from 28 different hospital wards in Skåne county, Sweden. Two weeks after discharge, information transfer was examined via review of primary care medical records. It was noted whether the discharge summary was... (More)

BACKGROUND: Discharge summary with medication report effectively counteracts drug-related problems among elderly patients due to insufficient information transfer in care transitions. However, this requires optimal transfer and use of the discharge summaries. This study aimed to examine information transfer with discharge summaries from hospital to primary care.

METHODS: A descriptive study with data consisting of discharge summaries of 115 patients, 75 years or older, using five or more drugs, collected during one week from 28 different hospital wards in Skåne county, Sweden. Two weeks after discharge, information transfer was examined via review of primary care medical records. It was noted whether the discharge summary was received (i.e. scanned to the primary care medical records), if the medication list was updated with drug changes and if a patient chart entry regarding medication or its follow-up was made in the primary care medical records. An electronic survey, which was sent to 151 primary care units in Skåne county, was used to examine experiences of the information transfer.

RESULTS: Out of 115 discharge summaries, 47 (41%) were found in the primary care medical records. Patient chart entries regarding medication or its follow-up were seen in 53 (46%) cases. Drug changes during hospitalisation were seen in 51 out of 76 patients without multidose drug dispensing. In 16 (31%) out of these cases, medication lists were updated in primary care medical records. In the electronic survey, 22 (21%) out of the 107 responding primary care units reported the discharge summary was often received on the day of discharge, while 71 (66%) respondents indicated the discharge summary was always/often received but later. Medication list updates and patient chart entries in the primary care medical records were always/often done upon receipt of the discharge summary according to 61 (57%) respondents.

CONCLUSION: The transfer of information was often deficient and the discharge summaries were insufficiently used. Many discharge summaries were lost, an insufficient proportion of medication lists were updated and patient chart entries were often lacking. These findings may increase the risk of medication errors and drug-related problems for elderly in care transitions.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Health Services Research
volume
18
issue
1
pages
9 pages
publisher
BioMed Central
external identifiers
  • scopus:85054747771
ISSN
1472-6963
DOI
10.1186/s12913-018-3581-0
language
English
LU publication?
yes
id
0bf412ec-632c-4cbd-b477-2d96f18e8207
date added to LUP
2018-10-13 12:05:45
date last changed
2019-02-20 11:31:31
@article{0bf412ec-632c-4cbd-b477-2d96f18e8207,
  abstract     = {<p>BACKGROUND: Discharge summary with medication report effectively counteracts drug-related problems among elderly patients due to insufficient information transfer in care transitions. However, this requires optimal transfer and use of the discharge summaries. This study aimed to examine information transfer with discharge summaries from hospital to primary care.</p><p>METHODS: A descriptive study with data consisting of discharge summaries of 115 patients, 75 years or older, using five or more drugs, collected during one week from 28 different hospital wards in Skåne county, Sweden. Two weeks after discharge, information transfer was examined via review of primary care medical records. It was noted whether the discharge summary was received (i.e. scanned to the primary care medical records), if the medication list was updated with drug changes and if a patient chart entry regarding medication or its follow-up was made in the primary care medical records. An electronic survey, which was sent to 151 primary care units in Skåne county, was used to examine experiences of the information transfer.</p><p>RESULTS: Out of 115 discharge summaries, 47 (41%) were found in the primary care medical records. Patient chart entries regarding medication or its follow-up were seen in 53 (46%) cases. Drug changes during hospitalisation were seen in 51 out of 76 patients without multidose drug dispensing. In 16 (31%) out of these cases, medication lists were updated in primary care medical records. In the electronic survey, 22 (21%) out of the 107 responding primary care units reported the discharge summary was often received on the day of discharge, while 71 (66%) respondents indicated the discharge summary was always/often received but later. Medication list updates and patient chart entries in the primary care medical records were always/often done upon receipt of the discharge summary according to 61 (57%) respondents.</p><p>CONCLUSION: The transfer of information was often deficient and the discharge summaries were insufficiently used. Many discharge summaries were lost, an insufficient proportion of medication lists were updated and patient chart entries were often lacking. These findings may increase the risk of medication errors and drug-related problems for elderly in care transitions.</p>},
  articleno    = {770},
  author       = {Caleres, Gabriella and Bondesson, Åsa and Midlöv, Patrik and Modig, Sara},
  issn         = {1472-6963},
  language     = {eng},
  month        = {10},
  number       = {1},
  pages        = {9},
  publisher    = {BioMed Central},
  series       = {BMC Health Services Research},
  title        = {Elderly at risk in care transitions When discharge summaries are poorly transferred and used -a descriptive study},
  url          = {http://dx.doi.org/10.1186/s12913-018-3581-0},
  volume       = {18},
  year         = {2018},
}