The transition of care from hospital to primary care provider (PCP) at discharge carries the potential for significant information loss. There is evidence that the timeliness and content of discharge communication are often unreliable during this handoff. Suboptimal transitions of care at discharge have been associated with adverse outcomes, and efficient solutions are required to transform the current state. Our specific aim was the achievement 90% documentation of hospitalist-PCP communication within 2 days of hospital discharge in <12 months.
As part of a grassroots collaborative improvement organization, pediatric hospitalist groups engaged in parallel quality improvement projects to improve the timeliness and reliability of discharge communication at their local institutions. After an initial face-to-face meeting, e-mail and regular conference calls were used to promote shared effort and learning. The study period lasted 12 months, with >16 weeks of continuous data required for inclusion.
The mean rate of documentation of timely discharge communication across the collaborative increased from 57% to 85% over the study period. For the 7 hospitals that were able to collect >16 weeks of data before July 2010, the mean rate of communication was >90%. Participants reported that the context of the collaborative contributed to their success.
Timely hospitalist-PCP communication was inconsistent at the beginning of the study. This low-resource quality improvement collaborative was able to achieve rapid improvement and resulted in improved perceptions of quality improvement knowledge among participants.