title: The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.
abstract: This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P < .01) but not at discharge (baseline, 14.9%; postintervention, 21.8%; P = .41). Residents cited the importance of PCP communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.
authors.affiliation: 1Stanford University, Palo Alto, CA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Kalanithi
authors.forename: Charles E
authors.initials: CE
authors.lastname: Coffey
authors.forename: Michelle
authors.initials: M
authors.lastname: Mourad
authors.forename: Arpana R
authors.initials: AR
authors.lastname: Vidyarthi
authors.forename: Harry
authors.initials: H
authors.lastname: Hollander
authors.forename: Sumant R
authors.initials: SR
authors.lastname: Ranji
mesh_terms: D003142:Communication; D004282:Documentation; D006760:Hospitalization; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D007400:Interprofessional Relations; D007857:Leadership; D008505:Medical Staff, Hospital; D019982:Organizational Case Studies; D010044:Outpatient Clinics, Hospital; D010819:Physician's Role; D058007:Physicians, Primary Care; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D058996:Quality Improvement / Q000458:organization & administration*; D012495:San Francisco
keywords: care transitions; quality improvement; residency training