Software improves patient satisfaction at discharge from hospital

When hospitalists use discharge communication software, patients and the outpatient doctors who carry out the care have better perceptions of the quality of the discharge process, according to new research published in the August issue of the Journal of Hospital Medicine.

The researchers go on to say that hospitalists are satisfied that the software works, although they find the systems more difficult to use than the paper based methods they are more familiar with.

Communication between physicians at the hospital - known as hospitalists - and primary care physicians or physicians at outpatient clinics can be a major challenge. That challenge can have major impacts on patient safety, re-admissions to the hospital and the financial well being of the healthcare system.

"We designed a computer software program to help doctors communicate with each other," said Dr. James Graumlich, Associate Professor of Medicine and Clinical Pharmacology, Chair in the Department of Medicine University of Illinois College of Medicine. "This research shows that the software can play a role in increasing the satisfaction of patients and their primary care physicians."

Part of that communication is the discharge summary, and problems occur when these are either not written, not handed on, or difficult to understand. Often patients have their first out-of-hospital appointment before the discharge notes have arrived with their primary care physician.

To assess their system, Dr. Graumlich and colleagues studied the experience of 631 patients and 70 hospitalists who had used the software between November 2004 and January 2007 in a teaching hospital in Illinois.

Compared to standard systems, computerized physician order entry (CPOE) software:

• Increased discharge preparedness scores from 17.2 to 17.7 for patients - a small but statistically significant increase
• Increased discharge quality scores from 16.5 to 17.2 for outpatient physicians - a small but statistically significant increase, but,
• Decreased the "easiness" of the discharge workflow from 7.9 to 6.5 for hospitalists - a significant decrease

"While our CPOE-based discharge software gave patients a slightly better experience as they were being discharged, we are aware that pharmacists and nurses still play a key role in the discharge process," Dr. Graumlich added. "Hospitalists need to recognize that patients benefit when these systems are used, and at the same time people building these systems need to work to solve the practical usage issues raised in our study."