The hospital transcription department at Happy's hospital gets kudos from me.
As many critics of hospitalist medicine know, for every hand off a voltage drop of information can occur. I personally make every effort I can to thoroughly review the chart when I come on to a new service for the week. I also try and leave detailed explanations about the status of my evaluations when I go off service.
But what about the discharge? Since Hospitalists generally don't follow their patients once they leave the hospital, there is a high probability of bad things happening between the time of discharge and the first appointment with the patient's outpatient internist or family medicine doctor. This no man's land can possibly lead to readmissions as neither patient nor hospitalist nor primary MD have any idea what's going on.
One way to reduce this voltage drop of information is to have systems in place that make sure the patient's primary MD gets the hospital discharge summary in a timely manner. So how do I define timely? My definition is 24 hours. I learned yesterday that 81.9% of hospitalist discharge summaries are transcribed in 0-12 hours. 14.8% are transcribed in 12-24 hours. That means almost 97% of all Happy's hospitalist discharge summaries are automatically sent to the patients primary MD (and any other subspecialist noted) in 24 hours or less.
Since we have a policy in our group of doing discharge summaries immediately upon discharge, patient information is received by the primary MD in almost all patients within 24 hours. I can't say the same for many subspecialty services where we are asked to readmit several weeks after their primary discharge, in which there is no discharge summary to be found.
Because I find many subspecialty groups do not dictate discharge summaries in a timely manner, I will dictate a letter to the primary MD on many patients I am consulted on. Why? Because I know that no discharge summary will be performed for a month or more. And I feel bad for the primary MD and patient for bouncing from doctor to doctor with no easily accessible written record (and especially no verbal communication either).
We live in a fragmented system of health care bouncing between hospitals and clinics with no easy way to hunt down information. I dictate these letters (which by the way are completely voluntary and uncompensated by anyone) out of a personally duty to limit the loss of information as patients bounce around in no man's land.
Happy's hospital group has also surveyed our referring primary MDs to learn how they like to be notified (phone call or not) upon discharge. We will call if they want. We won't if they don't. But they will always (97% of the time) get our discharge summary in 24 hours or less.
That's how you provide great quality care. And I can assure you, as bundled payments come our way, hospitals will intensify efforts to improve their in house processes to limit readmissions. Decreasing volatge drop is one such effort that will be taken. They will do this because they have to. Just like every hospital in this country hired chart police to scour physician documentation to maximize payment as determined by the Medicare National Bank.
So congrats Happy's hospital transcription department on a job well done. You are an example of how things should be done.
But what about the discharge? Since Hospitalists generally don't follow their patients once they leave the hospital, there is a high probability of bad things happening between the time of discharge and the first appointment with the patient's outpatient internist or family medicine doctor. This no man's land can possibly lead to readmissions as neither patient nor hospitalist nor primary MD have any idea what's going on.
One way to reduce this voltage drop of information is to have systems in place that make sure the patient's primary MD gets the hospital discharge summary in a timely manner. So how do I define timely? My definition is 24 hours. I learned yesterday that 81.9% of hospitalist discharge summaries are transcribed in 0-12 hours. 14.8% are transcribed in 12-24 hours. That means almost 97% of all Happy's hospitalist discharge summaries are automatically sent to the patients primary MD (and any other subspecialist noted) in 24 hours or less.
Since we have a policy in our group of doing discharge summaries immediately upon discharge, patient information is received by the primary MD in almost all patients within 24 hours. I can't say the same for many subspecialty services where we are asked to readmit several weeks after their primary discharge, in which there is no discharge summary to be found.
Because I find many subspecialty groups do not dictate discharge summaries in a timely manner, I will dictate a letter to the primary MD on many patients I am consulted on. Why? Because I know that no discharge summary will be performed for a month or more. And I feel bad for the primary MD and patient for bouncing from doctor to doctor with no easily accessible written record (and especially no verbal communication either).
We live in a fragmented system of health care bouncing between hospitals and clinics with no easy way to hunt down information. I dictate these letters (which by the way are completely voluntary and uncompensated by anyone) out of a personally duty to limit the loss of information as patients bounce around in no man's land.
Happy's hospital group has also surveyed our referring primary MDs to learn how they like to be notified (phone call or not) upon discharge. We will call if they want. We won't if they don't. But they will always (97% of the time) get our discharge summary in 24 hours or less.
That's how you provide great quality care. And I can assure you, as bundled payments come our way, hospitals will intensify efforts to improve their in house processes to limit readmissions. Decreasing volatge drop is one such effort that will be taken. They will do this because they have to. Just like every hospital in this country hired chart police to scour physician documentation to maximize payment as determined by the Medicare National Bank.
So congrats Happy's hospital transcription department on a job well done. You are an example of how things should be done.
Thank you for recognizing and appreciating what we do.
ReplyDeletePink (MT for 10 years)