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Improving communication between hospital and community physicians. Feasibility study of a handwritten, faxed hospital
1Department of Family Medicine, St Joseph's Community Health Centre, Hamilton, ON. paterson@ices.on.ca
Objective:
To assess the timing, legibility, and completeness of handwritten, faxed hospital discharge summaries as judged by family physicians and to obtain their opinion on the information categories on a standardized discharge summary form.
Design:
Fax survey of physicians for consecutive patients discharged from hospital over 8 weeks.
Setting:
Three wards in a tertiary care teaching hospital.
Participants:
One hundred two family physicians and general practitioners practising in Hamilton, Ont.
Main Outcome Measures:
Proportions of summaries that were received, received within 48 hours of discharge, legible, and complete; types of information missing from incomplete summaries; proportion of physicians satisfied with the information categories.
Results:
Of 271 consecutive patient discharges, 195 (72%) were eligible for study. Among those ineligible, 22 patients (8%) did not have a family doctor identified on their hospital records. Among records that did have a family physician identified, fax numbers were unavailable or unknown for 54 physicians (20%). One hundred two physicians completed 166 discharge summary assessments for a response rate of 85% (166/195). By 3 weeks after discharge, 138 discharge summaries (83%) had been received by patients' family doctors. Among those received, 86% were received within 48 hours of discharge; 92% were legible; and 88% were complete. Hospital doctors' signatures, patients' diagnoses, and follow-up plans were most frequently missing. Ninety-five percent of physicians were satisfied with the information categories included on the standardized form.
Conclusions:
Handwritten, faxed hospital discharge summaries were acceptable to family physicians for most patients. Criteria are needed for determining which patients require both handwritten and dictated discharge summaries.