Talking About Notes: Using a Design-Based Research Approach to Develop a Discharge Summary Template on a Geriatric...

Area of Science:

• Medical Education
• Geriatric Medicine
• Health Informatics

Background:

• Discharge summaries are crucial educational tools for medical trainees.
• Current geriatric rotation documentation often uses generic templates, not reflecting specialized geriatric care.
• The specific content for geriatric discharge summaries has not been previously defined.

Purpose of the Study:

• To explore and define the essential content for geriatric discharge summaries.
• To co-develop an instructional template and examples for geriatric discharge summaries.

Main Methods:

• A mixed-methods, design-based research approach was employed.
• The study involved assessing 68 discharge summaries and identifying documentation gaps.
• A consensus process was used to develop a geriatric-specific template with examples.

Main Results:

• Five geriatricians identified 14 gaps in existing discharge summaries.
• Many identified elements were generic, lacking geriatric-specific detail.
• A geriatric-specific template with explicit examples was developed to address identified gaps.

Conclusions:

• The developed template highlights the importance of documenting geriatric competencies.
• Barriers to quality notes include acceptance of low-quality norms, time constraints, and high document volume.
• The study encourages adapting the tools and fostering dialogue on improving note quality in geriatric care.