Primary care physicians often do not receive adequate patient information from the hospital-based physician following discharge, according to a review article in the February 28 issue of JAMA: The Journal of the American Medical Association.
According to background information in the article, "As the specialty of hospital medicine expands, the transfer of responsibility for patient care between hospital-based physicians and primary care physicians becomes increasingly common, creating a need to improve communication and information transfer between inpatient and outpatient physicians at hospital discharge. Timely transfer of accurate, relevant data about diagnostic findings, treatment, complications, consultations, tests pending at discharge, and arrangements for postdischarge follow-up" is important. "Delayed communication or inaccuracies in information transfer among health care professionals, particularly during the early postdischarge period, could have substantial implications for continuity of care, patient safety and patient and clinician satisfaction." The extent to which physicians successfully transfer timely and accurate patient information at hospital discharge is uncertain.
Sunil Kripalani, M.D., M.Sc., of the Emory University School of Medicine, Atlanta, and colleagues performed a review of medical literature to characterize the types and prevalence of deficits in communication and information transfer between hospital-based physicians and primary care physicians at hospital discharge. The researchers analyzed 55 observational studies investigating communication and information transfer at hospital discharge and 18 controlled studies evaluating the efficacy of interventions to improve information transfer.
The researchers found that direct communication between hospital physicians and primary care physicians during the discharge process occurred infrequently. Only 3 percent of primary care physicians reported being involved in discussions about discharge, and 17 percent to 20 percent reported always being notified about discharges.