Medication reconciliation and discharge communication from hospital to general practice: A quantitative analysis

Gusmeroli, Melinda, Perks, Stephen, and Bates, Nicole (2023) Medication reconciliation and discharge communication from hospital to general practice: A quantitative analysis. Australian Journal of Primary Health, 29 (6). pp. 679-685.

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Abstract

Background: The aim of this study was to assess the quality of effective discharge communication to primary practice from a hospital that uses ieMR (integrated electronic Medical Record), a complete electronic prescribing/medical record platform.

Methods: A retrospective quantitative analysis of 232 discharge encounters from a major tertiary hospital assessed the discharge summary quality; timeliness, completeness and medication information.

Results: Median time to discharge summary was 1 day. 22.0% of discharge summaries were incomplete at 30 days post discharge and 44.5% of discharge summaries were incomplete at 30 days post discharge if discharged on a weekend compared to weekday (P-value = 0.001). Rates of medication reconciliation were completed at approximately 35% at each point of the patient stay and 56.9% of patients had a GP discharge summary listing discharge medications. However, if certain progressive steps were completed (i.e. Home Medications recorded in ieMR, Discharge Reconciliation in ieMR, and Patient Discharge Medication Record in eLMs (Enterprise-wide Liaison Medication System)), then, the 'Medications on Discharge' was significantly more likely to be present in the discharge summary, at rates of 70.1%, 85.9%, and 98.6% respectively (P-value = 0.007, <0.001, <0.001). Conversely not doing these steps dropped rates of having medications listed in the discharge summary to 50.0%, 40.3% and 34.1% respectively.

Conclusions: This study assessed current discharge summary quality since the introduction of electronic medical records. It demonstrated the significant value of correct use of electronic programs, including performing all crucial steps of reconciliation. Targeted interventions in future studies that rectify the shortfalls in discharge communication are warranted.

Item ID: 80361
Item Type: Article (Research - C1)
ISSN: 1836-7399
Keywords: communication, discharge, discharge summary, health education, medication, medication systems, medication therapy management, pharmacy administration, reconciliation
Copyright Information: © 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
Date Deposited: 07 Feb 2024 00:13
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420304 General practice @ 50%
42 HEALTH SCIENCES > 4203 Health services and systems > 420306 Health care administration @ 50%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200203 Health education and promotion @ 100%
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