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Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study.

Publication ,  Journal Article
Greer, RC; Liu, Y; Crews, DC; Jaar, BG; Rabb, H; Boulware, LE
Published in: BMC health services research
August 2016

High quality hospital discharge communications about acute kidney injury (AKI) could facilitate continuity of care after hospital transitions and reduce patients' post-hospitalization health risks.We characterized the presence and quality (10 elements) of written hospital discharge communications (physician discharge summaries and patient instructions) for patients hospitalized with AKI at a single institution in 2012 through medical record review.In 75 randomly selected hospitalized patients with AKI, fewer than half of physician discharge summaries and patient instructions documented the presence (n = 33, 44 % and n = 10, 13 %, respectively), cause (n = 32, 43 % and n = 1, 1 %, respectively), or course of AKI (n = 23, 31 %, discharge summary only) during hospitalization. Few provided recommendations for treatment and/or observation specific to AKI (n = 11, 15 and 6, 8 % respectively). In multivariable analyses, discharge communications containing information about AKI were most prevalent among patients with AKI Stage 3, followed by patients with Stage 2 and Stage 1 (adjusted percentages (AP) [95 % CI]: 84 % [39-98 %], 43 % [11-82 %], and 24 % [reference], respectively; p trend = 0.008). AKI discharge communications were also more prevalent among patients with known chronic kidney disease (CKD) versus those without (AP [95 % CI]: 92 % [51-99 %] versus 39 % [reference], respectively, p = 0.02) and among patients discharged from medical versus surgical services (AP [95 % CI]: 73 % [33-93 %] versus 23 % [reference], respectively, p = 0.01). Communications featured 4 median quality elements. Quality elements were greater in communications for patients with more severe AKI (Stage 3 (number of additional quality elements (β) [95 % CI]: 2.29 [0.87-3.72]), Stage 2 (β [95 % CI]: 0.62 [-0.65-1.90]) and Stage 1 (reference); p for trend = 0.002).Few hospital discharge communications in AKI patients described AKI or provided recommendations for AKI care. Improvements in the quality of hospital discharge communications to improve care transitions of patients with AKI are needed.

Duke Scholars

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Published In

BMC health services research

DOI

EISSN

1472-6963

ISSN

1472-6963

Publication Date

August 2016

Volume

16

Start / End Page

449

Related Subject Headings

  • Renal Insufficiency, Chronic
  • Patient Discharge
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Health Policy & Services
  • Female
  • Cross-Sectional Studies
  • Continuity of Patient Care
 

Citation

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Greer, R. C., Liu, Y., Crews, D. C., Jaar, B. G., Rabb, H., & Boulware, L. E. (2016). Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study. BMC Health Services Research, 16, 449. https://doi.org/10.1186/s12913-016-1697-7
Greer, Raquel C., Yang Liu, Deidra C. Crews, Bernard G. Jaar, Hamid Rabb, and L Ebony Boulware. “Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study.BMC Health Services Research 16 (August 2016): 449. https://doi.org/10.1186/s12913-016-1697-7.
Greer RC, Liu Y, Crews DC, Jaar BG, Rabb H, Boulware LE. Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study. BMC health services research. 2016 Aug;16:449.
Greer, Raquel C., et al. “Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study.BMC Health Services Research, vol. 16, Aug. 2016, p. 449. Epmc, doi:10.1186/s12913-016-1697-7.
Greer RC, Liu Y, Crews DC, Jaar BG, Rabb H, Boulware LE. Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study. BMC health services research. 2016 Aug;16:449.
Journal cover image

Published In

BMC health services research

DOI

EISSN

1472-6963

ISSN

1472-6963

Publication Date

August 2016

Volume

16

Start / End Page

449

Related Subject Headings

  • Renal Insufficiency, Chronic
  • Patient Discharge
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Health Policy & Services
  • Female
  • Cross-Sectional Studies
  • Continuity of Patient Care