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2 results

  • Chapter 52 - Hospital-Based Care

  • from Section IV - Principles of Care for the Elderly
  • Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
  • Book:
    Reichel's Care of the Elderly
    Published online:
    30 June 2022
    Print publication:
    21 July 2022, pp 641-649

  • Summary

    As Medicare has focused more on hospital readmissions and care transitions over time, programs and movements aimed at providing geriatric-focused care have developed nationally. These programs aim to minimize and prevent hazards of hospitalization, decrease readmissions, provide safer transitions to the post-acute setting, and decrease length of stay while acknowledging and addressing specific care considerations of hospitalized older adults, such as dementia, sensory impairment, and mobility impairment. Inpatient geriatric assessments help providers tailor care plans to the specific needs of individual hospitalized older adults and determine their post-acute care needs, and also help with appropriate counseling of family and caregivers. Prevention measures are vital during hospitalization of older adults, who are at higher risk of delirium, pressure injury, falls, aspiration, malnutrition, sleep disturbances, and venous thromboembolism. Detailed transition plans and specialized discharge summaries are important to highlight the needs of older adults as they transition to post-acute care settings, and should allow for providers to resume the care plan seamlessly, including continuation of advanced care planning conversations.

  • Quality of psychiatric discharge summaries: a service evaluation following the introduction of an electronic discharge summary system

  • M. Abbas, T. Ward, M. H. Peivandi, E. McKenzie, K. Kujawska-Debiec, A. Hills
  • Journal:
    Irish Journal of Psychological Medicine / Volume 32 / Issue 4 / December 2015
    Published online by Cambridge University Press:
    20 January 2015, pp. 327-330
    Print publication:
    December 2015
  • Background

    There has been a recent move in psychiatry towards the use of electronic discharge (e-discharge) summaries in an effort to improve the efficiency of communication between primary and secondary care, but there are little data on how this affects the quality of information exchanged.

    Objective

    To evaluate the quality of psychiatric discharge summaries before and after the introduction of the e-discharge summary system.

    Methods

    A retrospective analysis of 50 dictated discharge summaries from 1 January to 1 July 2010 and of 50 e-discharge summaries from 1 January to 1 July 2012, evaluating for the inclusion of 15 key items of clinical information.

    Results

    The average total score of the dictated summaries (mean=9.5, s.d.=2.0) was significantly higher (p<0.001) than the e-discharge summaries (mean=6.7, s.d.=1.8). There were statistically significant differences in five of the standards: findings of physical examination (p<0.001), ICD-10 code (p<0.001), forensic history (p<0.001), alcohol history (p<0.001) and drug history (p<0.001).

    Conclusion

    Our results revealed a decline in the quality of discharge summaries following the introduction of an electronic system. The reasons for this are unclear and require further analysis. Specific suggestions will depend on the local need, but include improvements in software design and layout as well as better education and training.