title: A Discharge Planning Template for the Electronic Medical Record Improves Scheduling of Neurology Follow-up for Comanaged Seizure Patients.
abstract: OBJECTIVE
  We examined whether the addition of a standardized discharge planning template (DPT) for the electronic medical record facilitated scheduling of outpatient neurology follow-up appointments in children hospitalized with seizures.
  
  
  METHODS
  We reviewed medical records of patients discharged from a children's hospital with a diagnosis of seizures between January 2012 and June 2013. The study cohort included children who were admitted to the hospitalist service with neurology service comanagement. To facilitate interdisciplinary communication around discharge planning, a DPT was added to the neurology consult note in July 2012. Multivariate regression was used to determine whether the postimplementation time period was associated with the primary outcome (scheduling of outpatient neurology follow-up before discharge).
  
  
  RESULTS
  The final cohort included 300 patients, of whom 101 (34%) were discharged before implementation of the DPT, and 199 (66%) were discharged postimplementation of the DPT. The odds of having a neurology follow-up appointment scheduled before discharge was significantly higher after implementation of the DPT (adjusted odds ratio 2.8, 95% confidence interval 1.7-4.8) and for weekday as compared with weekend discharges (adjusted odds ratio 2.2, 95% confidence interval 1.2-3.9).
  
  
  CONCLUSIONS
  A discharge planning template for the electronic medical record can standardize the flow of discharge-related information between disciplines and may help expedite transitional care planning for hospitalized children, especially those with multiple consultants involved in their care. Given the inherent barriers to arranging outpatient services over the weekend, additional strategies may be necessary to enhance transitional care planning for patients going home over the weekend.
authors.affiliation: Section of Hospital Medicine Department of Pediatrics, and Children's Outcomes Research Program, University of Colorado School of Medicine, Aurora, Colorado; and mark.brittan@childrenscolorado.org.
authors.forename: Mark
authors.initials: M
authors.lastname: Brittan
authors.affiliation: Section of Hospital Medicine Department of Pediatrics, and.
authors.forename: Amy
authors.initials: A
authors.lastname: Tyler
authors.affiliation: Quality and Patient Safety Department, and.
authors.forename: Sara
authors.initials: S
authors.lastname: Martin
authors.affiliation: The Neuroscience Institute, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Konieczny
authors.affiliation: Section of Hospital Medicine Children's Outcomes Research Program, University of Colorado School of Medicine, Aurora, Colorado; and.
authors.forename: Michelle
authors.initials: M
authors.lastname: Torok
authors.affiliation: Department of Neurology, Neuroscience and Spine Institute, Kalispell, Montana.
authors.forename: Marcus
authors.initials: M
authors.lastname: Wheeler
authors.affiliation: Section of Hospital Medicine Department of Pediatrics, and.
authors.forename: Ann
authors.initials: A
authors.lastname: Boyer
keywords: electronic health records; hospital medicine; patient discharge; pediatrics; quality improvement; seizures