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Optimizing Sample Preparation for Cryogenic Electron Microscopy
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An Improvement Effort to Optimize Electronically Generated Hospital Discharge Instructions.

Whitney Chadwick1,2,3, Hannah Bassett4, Sarah Hendrickson5

  • 1Divisions of Pediatric Hospital Medicine and wchadwic@stanford.edu.

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|June 28, 2019
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Summary

Improving hospital discharge instructions (HDIs) through electronic health record redesign reduced discharge delays and enhanced patient and provider satisfaction. Standardized, accessible HDIs ensure safer patient transitions home.

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Area of Science:

  • Health Informatics
  • Patient Safety
  • Quality Improvement

Background:

  • Electronic health records (EHRs) can generate lengthy hospital discharge instructions (HDIs) with irrelevant information, hindering safe patient transitions.
  • A change in EHR systems created a cumbersome discharge workflow, increasing discharge delays and reducing the value of HDIs.

Purpose of the Study:

  • To decrease discharge delays caused by problematic HDIs.
  • To improve family and provider satisfaction with HDIs.

Main Methods:

  • Quality improvement methodology was used to redesign the EHR discharge navigator and HDIs.
  • Addressed issues including preparation time, formatting, standardization, and translation of HDIs.
  • Tracked discharge delays and evaluated HDI understandability and EHR usability pre- and post-intervention.

Main Results:

  • Discharge delays due to HDI errors decreased from 3.4 to 0.5 per month.
  • Parental ratings of HDI understandability improved significantly (P = .05).
  • Pediatric resident agreement on EHR usability increased from 9% to 67% (P < .001).

Conclusions:

  • Multidisciplinary collaboration led to the advance preparation of standardized HDIs.
  • The intervention successfully decreased discharge delays related to HDIs in a tertiary care hospital.