Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Discharge Summary Forms

Discharge Summary Forms

The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:

Flow Sheet

Flow Sheet

Flowsheets are valuable tools in nursing documentation. They enable healthcare professionals to efficiently record and monitor various patient assessments and measurements in a consolidated format.
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:

Guidelines and Strategies for Safe Computer Charting

Guidelines and Strategies for Safe Computer Charting

The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
Maintain Confidentiality and Security:

Methods of Documentation VI: Case Management Model

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Bundled de-implementation of recurring hospital orders with a novel electronic medical record order set.

BMJ open quality·2024

Same author

Handoffs and Equity: Impact of a Patient Distribution Model on Handoffs for Black Patients.

Journal of racial and ethnic health disparities·2024

Same author

Development and Evaluation of a Direct Care Hospitalist Service Internal Medicine Sub-internship Rotation.

Journal of general internal medicine·2024

Same author

Implementation of a Real-Time Documentation Assistance Tool: Automated Diagnosis (AutoDx).

Applied clinical informatics·2024

Same author

Improving Equity and Accuracy in Admission Medication Reconciliation.

American journal of medical quality : the official journal of the American College of Medical Quality·2024

Same author

Brief Report: Discordance Between Liquid and Tissue Biopsy-Based Next-Generation Sequencing in Lung Adenocarcinoma at Disease Progression.

Clinical lung cancer·2023

Search research articles

Related Experiment Video

Updated: Jan 8, 2026

A Semi-automated Approach to Preparing Antibody Cocktails for Immunophenotypic Analysis of Human Peripheral Blood

A Semi-automated Approach to Preparing Antibody Cocktails for Immunophenotypic Analysis of Human Peripheral Blood

Published on: February 8, 2016

Automating pending labs list into discharge summaries.

Khanh T Nguyen¹, Chukwunedum Aniemeka², Nia Feaster³

¹Section of Hospital Medicine, University of Chicago Department of Medicine, Chicago, Illinois, USA knguyen@bsd.uchicago.edu.

BMJ Open Quality

|December 12, 2025

Summary

Automating pending lab results in discharge summaries significantly improved documentation. This quality improvement initiative enhances patient safety during post-acute care transitions by ensuring critical test results are communicated effectively.

Keywords:

Diagnostic errors Patient Discharge Patient Handoff Transitions in care

More Related Videos

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Published on: November 10, 2016

A Plasma Sample Preparation for Mass Spectrometry using an Automated Workstation

A Plasma Sample Preparation for Mass Spectrometry using an Automated Workstation

Published on: April 24, 2020

Related Experiment Videos

Last Updated: Jan 8, 2026

A Semi-automated Approach to Preparing Antibody Cocktails for Immunophenotypic Analysis of Human Peripheral Blood

A Semi-automated Approach to Preparing Antibody Cocktails for Immunophenotypic Analysis of Human Peripheral Blood

Published on: February 8, 2016

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Published on: November 10, 2016

A Plasma Sample Preparation for Mass Spectrometry using an Automated Workstation

A Plasma Sample Preparation for Mass Spectrometry using an Automated Workstation

Published on: April 24, 2020

Area of Science:

Health Informatics
Patient Safety
Quality Improvement

Background:

Incomplete communication of pending test results during post-acute care transitions can lead to patient harm and diagnostic errors.
A quality improvement initiative was launched to evaluate the impact of automating pending laboratory results into discharge summaries.

Purpose of the Study:

To assess the effectiveness of an automated system for communicating pending laboratory and pathology results.
To improve the documentation and follow-up of pending tests during patient discharge.

Main Methods:

A "SmartLink" tool was integrated into the EpicCare electronic health record to automatically populate pending studies into discharge summaries.
A pre-post review of 2-month discharge encounters was conducted to compare documentation rates before and after implementation.

Main Results:

The proportion of discharge summaries mentioning all pending labs increased significantly from 26.9% pre-intervention to 90.4% post-intervention (p<0.01).
While the frequency of reporting abnormal results in follow-up notes showed a trend towards significance, no difference was observed in overall reporting rates.

Conclusions:

Automating the inclusion of pending studies in discharge summaries substantially enhanced the documentation of these critical results.
Further efforts are necessary to address the complexities of post-acute care transitions and ensure the receipt and follow-up of pending test communications.