SHM Converge Scientific Abstract ePoster Gallery-Improving the After Visit Summary to Optimize Discharge Education

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This project aimed to improve discharge education by adding a standardized SmartPhrase to the “Message to Patient” section of the After Visit Summary (AVS). The team noticed that this optional free-text section was often left blank, missing an opportunity to highlight important elements of the discharge plan.<br /><br />A SmartPhrase was developed with input from resident physicians, hospitalists, nurses, and patient representatives. It was then piloted through surveys of residents, nurses, and patient representatives, and later implemented on Internal Medicine teaching teams using two PDSA cycles: first training existing residents, then orienting new interns.<br /><br />Survey results were positive. Residents, nurses, and patient representatives felt the tool would improve patient understanding of discharge medications and follow-up care. It was also considered easy to use, typically taking about 5 minutes to complete, and was widely adopted by providers. Nursing staff incorporated it into their workflow and reported that it improved their ability to deliver discharge education.<br /><br />Chart review showed adoption of the SmartPhrase increased by 33% between PDSA cycles, rising from 37% to 70% after onboarding new interns and providing additional training.<br /><br />Strengths of the intervention included low cost, ease of use, and positive impact on patient understanding of medications and follow-up/imaging. Weaknesses included the lack of explicit information on the reason for admission and specific follow-up appointments, as well as the need for manual entry.<br /><br />Overall, the project demonstrated that a simple EMR-based SmartPhrase can be successfully implemented to improve discharge communication and may be generalizable to other services.

Asset Subtitle

David Y. Jackson

Meta Tag

Author List Amanda Kennedy, David Y. Jackson, Juvena R. Hitt, Preetika Muthukrishnan

Category Innovations

Concept After-Visit Summary

Concept Discharge Education

Concept MiCast Smart Phrase

Concept Patient Understanding

Concept Message to Patient

Distinguished Non-Finalist

Presenter Organization University of Vermont Medical Center

Presenting Author David Y. Jackson

Track Quality Improvement

Keywords

discharge education

SmartPhrase

After Visit Summary

AVS

patient understanding

medication instructions

follow-up care

electronic medical record

PDSA cycles

hospital discharge communication

After-Visit Summary

Discharge Education

MiCast Smart Phrase

Patient Understanding

Message to Patient