Transition to home care: quality of mental health, pharmacy, and medical history information.
OBJECTIVE
To assess the completeness and accuracy of clinical information provided by referral sources to visiting nurses for patients admitted to receive home health care.


METHODS
Clinical referral information for a representative sample of 243 older adults admitted to receive skilled home-health nursing was compared to medical record information from home-health charts and in-home research interviews to determine their concordance. Measures used included referral information, home-care chart documentation, in-home nurse review of medications, medication allergies, caregiver contact information, cognitive status, depression status, and follow-up plan.


RESULTS
There were medication discrepancies between in-home nurse review and admission information in 215 cases (88.4%). Clinical information on medication allergies was lacking from referrers in 85 cases (34.9%). No information was provided by the referrers about cognitive status in 38 (73%) cases classified as cognitively impaired and in only 2 of 35 cases with major depression identified with the Structured Clinical Interview for Axis I Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID), was depression related information provided by referrers.


CONCLUSIONS
The primary finding of this study is that during a transfer of an older adult to the home care service sector, essential clinical information is often missing, and there are significant discrepancies between medication regimens. These findings support the need for both educational initiatives and technology to address the complex care needs of older adults across settings to reduce the risk for medication errors and poor outcomes.
Brown
Ellen L
EL
Stein Gerontological Institute, Miami Jewish Home and Hospital, Miami, Florida 33137, USA. ebrown@mjhha.org
Raue
Patrick J
PJ
Mlodzianowski
Amy E
AE
Meyers
Barnett S
BS
Greenberg
Rebecca L
RL
Bruce
Martha L
ML
D000368:Aged; D003152:Community Health Nursing; D003266:Continuity of Patient Care; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000592:standards; D006707:Homes for the Aged / Q000592:standards; D006801:Humans; D007255:Information Services / Q000592:standards; D008297:Male; D008499:Medical Records / Q000592:standards; D008508:Medication Errors; D009735:Nursing Homes / Q000592:standards; D010360:Patient Transfer / Q000592:standards*; D011785:Quality Assurance, Health Care