Background: Hospital discharge summaries are critical to transitions of care as they are oftentimes the only substantive form of communication that accompanies patients to their next care setting. The lack of interoperability in our healthcare IT ecosystem amplifies the need for discharge summaries to mitigate subsequent duplication of services and increased costs. These documents must be accurate and provide trustworthy information, but the process of writing an effective discharge summary is seldom formally taught in graduate medical education. Given the important role they perform, it is critical that burgeoning physicians are better equipped to produce quality discharge summaries. In the absence of a formalized curriculum, however, learning the skills to write a discharge summary relies heavily on resident peers teaching peers. This produces variable document quality.
Purpose: At the University of Texas at Austin, a unique partnership between the Design Institute for Health (DIH) and the Division of Hospital Medicine at Dell Medical School (DHM) was created to improve transitions of care. Among other deliverables, this partnership developed a toolkit to standardize discharge documentation education.
Description: In conjunction with the DHM, CommUnityCare and Austin Geriatric Specialists, the DIH developed a toolkit to enhance the standardization of discharge summaries (DS). The toolkit utilized human-centered design methods to identify three main components of an effective discharge summary: appropriate content, organized presentation, and emotional reactions to DS, specifically perceived trust. Based on these insights and the ACGME’s framework of competency domains for system-based practices, we identified nine competencies required to write effective discharge summaries. These were incorporated into the DIH toolkit, which consisted of checklists, educational guidelines, templates and workshop activities to improve the quality of DS. The contents of this toolkit were utilized to create traditional educational programming in the form of conferences for incoming residents.
Conclusions: Discharge summaries are crucial for successful transitions of care and yet there is a lack of standardized curricula for trainees to build necessary competencies. Using a novel blend of human-centered design methods and ACGME requirements, we created an innovative curriculum that utilized effective DS teaching tools for graduate medical education. We aim to integrate this work further into our orientation curriculum and longitudinal didactics.