title: Communication and information deficits in patients discharged to rehabilitation facilities: an evaluation of five acute care hospitals.
abstract: BACKGROUND
  The quality of discharge documentation in patients discharged to rehabilitation centers and other subacute facilities is less well studied than that of patients discharged home.
  
  
  OBJECTIVE
  To evaluate the quality of information transfer among patients discharged from acute hospitals to subacute facilities across an integrated healthcare delivery system.
  
  
  METHODS
  Retrospective evaluation of discharge documentation packets of selected patients.
  
  
  METHODS
  Five acute care hospitals of the Partners Healthcare System.
  
  
  METHODS
  We measured the presence of specific data elements required to safely care for patients after discharge, including all data elements required by the Joint Commission on Accreditation of Healthcare Organizations (TJC).
  
  
  RESULTS
  A total of 1501 discharge documentation packets were reviewed from March 2005 through June 2007. Only 1055 (70.3%) discharge summaries had all the information required by TJC, with physical examination at admission and condition at discharge most often missing (in 11.4% and 14.2% of cases, respectively). Other deficiencies not mandated by TJC included a list of preadmission medications (missing in 20.3%) and reasons for changes in these medications at discharge (35.3%), mention of pending test results (47.2%), and postdischarge management and follow-up plans (11.1%).
  
  
  CONCLUSIONS
  We found room for improvement in the inclusion of data elements required for the safe transfer of patients from acute hospitals to subacute facilities, especially in areas such as medication reconciliation, pending test results, and adequate follow-up plans.
authors.affiliation: Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts 02120-1613, USA. egandara@partners.org
authors.forename: Esteban
authors.initials: E
authors.lastname: Gandara
authors.forename: Thomas
authors.initials: T
authors.lastname: Moniz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ungar
authors.forename: Jason
authors.initials: J
authors.lastname: Lee
authors.forename: Myrna
authors.initials: M
authors.lastname: Chan-Macrae
authors.forename: Terrence
authors.initials: T
authors.lastname: O'Malley
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Schnipper
mesh_terms: D000046:Academic Medical Centers / Q000379:methods / Q000592:standards*; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards; D005500:Follow-Up Studies; D006760:Hospitalization; D006764:Hospitals, Community / Q000379:methods / Q000592:standards*; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D010351:Patient Discharge / Q000592:standards*; D010360:Patient Transfer / Q000592:standards*; D012047:Rehabilitation Centers / Q000592:standards*; D012189:Retrospective Studies