title: Design of an orthopaedic-specific discharge summary.
abstract: Patients undergoing orthopaedic procedures experience major changes in function and daily routines upon their return home. Discharge summaries are an important communication tool that may play a role in optimizing a safe transition from hospital. Current care gaps and key elements of an ideal discharge summary specific for orthopaedic population are unknown. We sought to identify the challenges of current orthopaedic discharge summaries and to determine key elements of an ideal document.
  
  
  
  Qualitative study survey using semi-structured interviews with a sample of 17 patients and clinicians representing diverse professions, backgrounds, and practice settings. We used the constant comparative method of qualitative analysis to define the experiences and perceptions of quality gaps and strategies to improve orthopaedic-specific discharge summaries.
  
  
  
  We identified 3 major themes describing factors perceived to be limiting the quality of current discharge summaries: 1) physician-centric documentation and the absence of a comprehensive, inter-professional perspective; 2) access to resources and health informatics; and 3) process variations in document creation and dissemination.
  
  
  
  Clinicians and patients identified several factors limiting the quality of discharge summaries among orthopaedic inpatients. Incorporating these elements could improve hospital transitions.
authors.affiliation: Division of General Internal Medicine, Mount Sinai Hospital, 600 University Avenue, Room 428, Toronto, ON, M5G 1X5, Canada. christine.soong@utoronto.ca.|Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada. christine.soong@utoronto.ca.
authors.forename: Christine
authors.initials: C
authors.lastname: Soong
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Bochra
authors.initials: B
authors.lastname: Kurabi
authors.affiliation: Inter-department Division of Critical Care Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Exconde
authors.affiliation: Division of General Internal Medicine, Mount Sinai Hospital, 600 University Avenue, Room 428, Toronto, ON, M5G 1X5, Canada.
authors.forename: Faiqa
authors.initials: F
authors.lastname: Tajammal
authors.affiliation: Division of General Internal Medicine, Mount Sinai Hospital, 600 University Avenue, Room 428, Toronto, ON, M5G 1X5, Canada.|Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D000368:Aged; D003142:Communication; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006761:Hospitals; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000592:standards*; D010351:Patient Discharge; D063886:Patient Discharge Summaries / Q000592:standards*
keywords: Comanagement; Hip fracture; Hospitalist; Quality improvement