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Assessing Documentation of Critical Imaging Result Follow-up Recommendations in Emergency Department Discharge Instructions
Authors:Anurag Gupta  Ronilda Lacson  Patricia C. Balthazar  Shan Haq  Adam B. Landman  Ramin Khorasani
Affiliation:1.Center for Evidence-Based Imaging,Brigham and Women’s Hospital,Brookline,USA;2.Department of Emergency Medicine,Brigham and Women’s Hospital,Boston,USA;3.Harvard Medical School,Boston,USA
Abstract:
To facilitate follow-up of critical test results across transitions in patient care settings, we implemented an electronic discharge module that enabled care providers to include follow-up recommendations in the discharge instructions. We assessed the impact of this module on documentation of follow-up recommendations for critical imaging findings in Emergency Department (ED) discharge instructions. We studied 240 patients with critical imaging findings discharged from the ED before (n?=?80) and after (n?=?160) implementation of the module. We manually reviewed hand-written forms and electronic discharge instructions to determine if follow-up recommendations were documented. Follow-up recommendations in ED discharge instructions increased from 60.0% (48/80) to 73.8% (118/160) post-module implementation (p?=?0.03), a relative increase of 23%. There was no significant change in the rate of documented critical imaging findings in the discharge instructions (77.5% [62/80] before the intervention and 76.9% [123/160] after the intervention; p?=?0.91). Implementation of a discharge module was associated with increased documentation of critical imaging finding follow-up recommendations in ED discharge instructions. However, one in four patients still did not receive adequate follow-up recommendations, suggesting further opportunities for performance improvement exist.
Keywords:
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