title: Improving handoff communication from hospital to home: the development, implementation and evaluation of a personalized patient discharge letter.
abstract: OBJECTIVE
  To develop, implement and evaluate a personalized patient discharge letter (PPDL) to improve the quality of handoff communication from hospital to home.
  
  
  METHODS
  From the end of 2006-09 we conducted a quality improvement project; consisting of a before-after evaluation design, and a process evaluation.
  
  
  METHODS
  Four general internal medicine wards, in a 1024-bed teaching hospital in Amsterdam, the Netherlands.
  
  
  METHODS
  All consecutive patients of 18 years and older, admitted for at least 48 h.
  
  
  METHODS
  A PPDL, a plain language handoff communication tool provided to the patient at hospital discharge.
  
  
  METHODS
  Verbal and written information provision at discharge, feasibility of integrating the PPDL into daily practice, pass rates of PPDLs provided at discharge.
  
  
  RESULTS
  A total of 141 patients participated in the before-after evaluation study. The results from the first phase of quality improvement showed that providing patient with a PPDL increased the number of patients receiving verbal and written information at discharge. Patient satisfaction with the PPDL was 7.3. The level of implementation was low (30%). In the second phase, the level of implementation improved because of incorporating the PPDL into the electronic patient record (EPR) and professional education. An average of 57% of the discharged patients received the PPDL upon discharge. The number of discharge conversations also increased.
  
  
  CONCLUSIONS
  Patients and professionals rated the PPDL positively. Key success factors for implementation were: education of interns, residents and staff, standardization of the content of the PPDL, integrating the PPDL into the electronic medical record and hospital-wide policy.
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Buurman
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Verhaegh
authors.affiliation: Department of Quality Assurance and Process Innovation, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Marian
authors.initials: M
authors.lastname: Smeulers
authors.affiliation: Department of Quality Assurance and Process Innovation, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Hester
authors.initials: H
authors.lastname: Vermeulen
authors.affiliation: Department of Internal Medicine, Section of Infectious Disease, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Geerlings
authors.affiliation: Department of Quality, Cordaan, Amsterdam, The Netherlands.
authors.forename: Susanne
authors.initials: S
authors.lastname: Smorenburg
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Sophia E
authors.initials: SE
authors.lastname: de Rooij
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D057286:Electronic Health Records / Q000592:standards; D005260:Female; D006784:Hospitals, Teaching / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge / Q000592:standards*; D017060:Patient Satisfaction; D057766:Policy; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards
keywords: handover; patient discharge; patient satisfaction; patient-centered care; patient-centered communication