Automated Versus Conventional Hospital Discharge Summaries and Prescriptions

NCT ID: NCT00670865

Last Updated: 2010-04-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

209 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-05-31

Study Completion Date

2008-07-31

Brief Summary

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The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.

Detailed Description

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For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care.

Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community.

We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.

Conditions

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Patient Discharge Continuity of Patient Care Medical Records Systems, Computerized Hospital Information Systems

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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eDischarge

The eDischarge arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use the electronic discharge summary program.

Group Type EXPERIMENTAL

Electronic discharge summary system

Intervention Type OTHER

The customized electronic discharge summary program will be used to generate patient discharge summaries.

Traditional

The traditional arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use "traditional," dictated discharge summaries.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Electronic discharge summary system

The customized electronic discharge summary program will be used to generate patient discharge summaries.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Hospitalization on General Internal Medicine ward at St. Michael's Hospital

Exclusion Criteria

* Transfer to another service
* Death during admission
* Remains in hospital past dates specified in study protocol
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Unity Health Toronto

OTHER

Sponsor Role lead

Responsible Party

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St. Michael's Hospital

Principal Investigators

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David M Maslove, MD

Role: PRINCIPAL_INVESTIGATOR

Unity Health Toronto

Chaim M Bell, MD, PhD, FRCPC

Role: PRINCIPAL_INVESTIGATOR

St. Michael's Hospital; University of Toronto

Locations

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St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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van Walraven C, Laupacis A, Seth R, Wells G. Dictated versus database-generated discharge summaries: a randomized clinical trial. CMAJ. 1999 Feb 9;160(3):319-26.

Reference Type BACKGROUND
PMID: 10065073 (View on PubMed)

van Walraven C, Seth R, Austin PC, Laupacis A. Effect of discharge summary availability during post-discharge visits on hospital readmission. J Gen Intern Med. 2002 Mar;17(3):186-92. doi: 10.1046/j.1525-1497.2002.10741.x.

Reference Type BACKGROUND
PMID: 11929504 (View on PubMed)

Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007 Feb 28;297(8):831-41. doi: 10.1001/jama.297.8.831.

Reference Type BACKGROUND
PMID: 17327525 (View on PubMed)

Maslove DM, Leiter RE, Griesman J, Arnott C, Mourad O, Chow CM, Bell CM. Electronic versus dictated hospital discharge summaries: a randomized controlled trial. J Gen Intern Med. 2009 Sep;24(9):995-1001. doi: 10.1007/s11606-009-1053-2. Epub 2009 Jul 16.

Reference Type RESULT
PMID: 19609623 (View on PubMed)

Other Identifiers

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07-364

Identifier Type: -

Identifier Source: org_study_id

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