Discharge Summaries and Hospital Readmissions

By Jane Farrell

Good discharge summaries for heart-failure patients can make the difference between a quick recovery and hospital readmission, according to Yale School of Medicine researchers.

The findings were published in Circulation: Cardiovascular Quality and Outcomes.

A discharge summary is designed to help outside physicians understand what happened to patientsi n the hospital, but in reality, it’s served to help medical billing, according to lead author Dr. Leora Horwitz, adjunct associate professor of internal medicine at Yale School of Medicine. “The medical community hasn’t really made full use of discharge summaries as a tool for transitions,” she said.

According to a news release from Yale, Horwitz and her team analyzed data from Telemonitoring to Improve Heart Failure Outcomes (Tele-HF), a large multicenter study of patients hospitalized with heart failure. The study contained more than 1,500 discharge summaries from 46 hospitals across the country.

For a discharge summary to be most effective, Horwitz said, it has to be timely, it has to be sent to the outside physician, and it has to include useful information.

In their investigation, the researchers found that hospitals varied widely in the quality of their discharge summaries, and that even high-quality hospitals produced substandard summaries. No hospital, the research said, consistently provided high-quality summaries.

The team also found that patients whose summaries were better or who were sent to outside clinicians had lower readmission rates.

“This study tells us for the first time that it is actually worth spending the time and effort to improve discharge communication, and patients do seem to benefit,” said Horwitz.