Improving the Hospitalist-Primary Care Provider (PCP) Discharge Handoff

Inconsistencies in the discharge process provide an opportunity to standardize that process, reduce variability and improve information flow during handoffs. Improving the communication of critical patient information should in turn lead to decreased readmissions. The goal of this project was to show improvement in seven-day postdischarge outpatient follow-up appointments with primary care providers (PCPs). Additional project metrics included percentage of patients whose PCP received a phone call upon time of discharge with an update on patient status, percentage of discharge summaries dictated on the same calendar day of discharge so the PCP gets information as soon as possible, and percentage of discharge summaries signed and verified and pushed from the inpatient electronic health record (EHR) to outpatient EHR.

The change/implementation strategy included using the DMAIC (define, measure, analyze, improve, control) process, Lean Six Sigma tools, and continued monitoring of metrics over time. Initial results showed an increase from 62 percent to 75 percent in seven-day follow-up appointments, increase from 70 percent to 100 percent in phone calls to PCPs, increase from 96 percent to 100 percent in discharge summaries and increase from 90 percent to 98 percent in discharge summaries signed.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/