The Joint Commission Journal on Quality and Patient Safety
Development and Evaluation of an Electronic Health Record–Based Best-Practice Discharge Checklist for Hospital Patients
Section snippets
Setting
This study was conducted at Stanford University Medical Center (Stanford, California), an academic medical center with more than 25,000 inpatient admissions per year and approximately 2,100 medical staff and 700 interns and residents. Our Institutional Review Board considered the study as quality improvement and therefore “exempt.”
Phase I. Determining the Need and Modality of Checklist (January–March 2013)
Before this study, we had anecdotal evidence that there was considerable variation in discharge practices at our hospital, in part because of variation in methods of
Phase I. Determining the Need and Modality of Checklist
The internal medicine survey was sent to 109 residents and had 76 participants (response rate, 69.7%), of which 25 (32.9%) were first-year residents, 26 (34.2%) were second-year, and 25 (32.9%) were third-year. Participants’ perceived usefulness of checklists in standardizing and improving the patient care process was reported on an ascending scale from 1 (low) to 100 (high) and had a mean of 66.4, which did not differ by year of resident (p = .92). Currently used methods for remembering
Discussion
The objective of this study was to develop, implement, and evaluate an EHR best-practice discharge checklist for hospital patients. Best-practice discharge checklists have been described previously, and our checklist items are consistent with those previously proposed.8., 9. To our knowledge, there are no previous studies that have characterized physicians’ methods for remembering discharge tasks, their perceived value of checklists, and their preferred modality of checklists. Few studies have
Conclusions
We describe the need for a best-practice discharge checklist and propose that an EHR smart-phrase tool is a novel and physician-supported mechanism for checklist delivery. Using an EHR checklist improves physicians’ perceived confidence in discharge, reminds them to complete necessary discharge tasssssks, and increases the perceived efficiency of the discharge process.
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