SHM Converge Scientific Abstract ePoster Gallery-Discharge Summary Routing

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This quality improvement project evaluated methods to increase discharge summary routing from Duke Hospital Medicine to the patient’s follow-up primary care physician (PCP), improving communication during transitions of care. The study included patients discharged between 8/1/20 and 11/16/21.

Three phases were assessed:
1. <strong>Baseline (8/1/20–11/30/20):</strong> Routing was optional and not automated.
2. <strong>Manual Routing Intervention (12/1/20–8/31/21):</strong> Providers received education, email reminders, audit feedback, peer comparison, and a “vanishing tip” reminder in the discharge summary template.
3. <strong>Auto Routing Intervention (9/1/21–11/16/21):</strong> Automated routing was built into the electronic medical record as a forced function at final signature.

Results showed that the manual intervention improved routing rates by <strong>20.7% overall</strong> to <strong>42.6%</strong>, and by <strong>25.2%</strong> for Duke Primary Care patients to <strong>49.3%</strong>. However, substantial gaps remained. After implementing automated routing, rates improved by an additional <strong>25.4% overall</strong> to <strong>68%</strong>, and by <strong>38.3%</strong> for Duke Primary Care patients to <strong>87.6%</strong>.

Most non-routed discharge summaries occurred because the patient’s PCP was not correctly identified in the electronic medical record.

The main conclusion was that education and reminders can help, but automated workflow changes are much more effective. The project supports the idea that forcing key safety steps into the system produces better results than relying on provider behavior change alone.

Asset Subtitle

David Gallagher

Meta Tag

Author List Barbara Walton, David Gallagher, Elizabeth Anderson, Jonathan Lovins, Kevin Shah, Kristian Knutsen, Lanie Dreibelbis, Stephen Telloni

Category Research

Concept Discharge Summary

Concept Automation

Concept Care Transition

Concept Primary Care Physician

Concept Workflow Automation

Distinguished Non-Finalist

Presenter Organization Duke University

Presenting Author David Gallagher

Track Transitions of Care

Keywords

discharge summary

primary care physician

transition of care

quality improvement

routing rates

manual intervention

automated routing

electronic medical record

hospital medicine

patient safety

Discharge Summary

Automation

Care Transition

Primary Care Physician

Workflow Automation