Patient DischargeNCT00670865
Automated Versus Conventional Hospital Discharge Summaries and Prescriptions
A study testing Electronic discharge summary system in people with Patient Discharge and Continuity of Patient Care, run by Unity Health Toronto at 1 site in Canada.
Trial summary
The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Patient Discharge, Continuity of Patient Care, Medical Records Systems, Computerized
- What is being tested?
- Electronic discharge summary system
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 209 participants
- Where
- 1 siteCanada
- Study dates
- May 2008to Jul 2008
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Hospitalization on General Internal Medicine ward at St. Michael's Hospital
Who cannot join
- Transfer to another service
- Death during admission
- Remains in hospital past dates specified in study protocol
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Automated Versus Conventional Hospital Discharge Summaries and Prescriptions: A Randomized Controlled Trial
The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.
Read the detailed description
For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care.
Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community.
We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.
- Conditions
- Patient Discharge, Continuity of Patient Care, Medical Records Systems, Computerized, Hospital Information Systems
- Being tested
- Electronic discharge summary system
- Keywords
- Hospitalization, Continuity of care, Discharge summary, Quality improvement, Medical records systems, Hospital information systems
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Electronic discharge summary systemOther
The customized electronic discharge summary program will be used to generate patient discharge summaries.
| Study group | Role | What they receive |
|---|---|---|
| eDischarge | Experimental | The eDischarge arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use the electronic discharge summary program. Receives: Other: Electronic discharge summary system |
| Traditional | No intervention | The traditional arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use "traditional," dictated discharge summaries. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Measured: Satisfaction score assessment form to be sent one week after patient's discharge from hospital. If form is not returned in 14 days, a reminder and second form will be sent.
Secondary outcomes (6)
St. Michael's Hospital housestaff satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Measured: Housestaff will fill out form upon completion of the rotation during which the study has been performed
Completion of specialist outpatient workups at St. Michael's Hospital recommended during course of hospitalization
Measured: Within the first 30 days of patient's discharge from hospital
Patient visits to Emergency Room at St. Michael's Hospital
Measured: Within the first 30 days after patient's discharge from hospital
Patient/proxy care transition assessment through the use of the CTM-3.
Measured: Phone call made to patient or proxy one week after discharge. If patient/proxy is not reached, follow up calls will be made daily until patient/proxy is reached.
Prescribing errors as assessed by comparing discharge summary to inpatient record
Measured: Upon discharge
Patient readmissions to St. Michael's Hospital
Measured: Within 30 days of discharge
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 May 2008 (estimated)
- Study startMay 2008
- Primary completionJun 2008
- Study completionJul 2008
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Patient DischargeStudies of the same condition, open and under way.
- More trials run by Unity Health TorontoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 209 participants (actual)
Sponsor and investigators
- Lead sponsor
- Unity Health Toronto
- Sponsor type
- University, hospital or other
- Investigators
- David M Maslove, MD, Principal investigator, Unity Health TorontoChaim M Bell, MD, PhD, FRCPC, Principal investigator, St. Michael's Hospital; University of Toronto
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00670865
- Sponsor's protocol ID
- 07-364
- Status last verified
- Apr 2010
- First submitted
- 7 Apr 2008
- Last updated
- 16 Apr 2010
- Results posted
- No
- Data monitoring committee
- No
Publications
van Walraven C, Laupacis A, Seth R, Wells G. Dictated versus database-generated discharge summaries: a randomized clinical trial. CMAJ. 1999 Feb 9;160(3):319-26.
PubMed 10065073van Walraven C, Seth R, Austin PC, Laupacis A. Effect of discharge summary availability during post-discharge visits on hospital readmission. J Gen Intern Med. 2002 Mar;17(3):186-92. doi: 10.1046/j.1525-1497.2002.10741.x.
PubMed 11929504Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007 Feb 28;297(8):831-41. doi: 10.1001/jama.297.8.831.
PubMed 17327525Maslove DM, Leiter RE, Griesman J, Arnott C, Mourad O, Chow CM, Bell CM. Electronic versus dictated hospital discharge summaries: a randomized controlled trial. J Gen Intern Med. 2009 Sep;24(9):995-1001. doi: 10.1007/s11606-009-1053-2. Epub 2009 Jul 16.
PubMed 19609623
Study at a glance
From the registry record, last updated by the sponsor on 16 Apr 2010. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Automated Versus Conventional Hospital Discharge Summaries and Prescriptions: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT00670865
- Acronym / sponsor ID
- 07-364
- Conditions
- Patient Discharge, Continuity of Patient Care, Medical Records Systems, Computerized, Hospital Information Systems
- Keywords
- Hospitalization, Continuity of care, Discharge summary, Quality improvement, Medical records systems, Hospital information systems
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 209 participants (actual)
- Lead sponsor
- Unity Health TorontoUniversity, hospital or other
- Study start
- May 2008
- Primary completion
- Jun 2008 (actual)
- Study completion
- Jul 2008 (actual)
- First posted
- 2 May 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether a semi-automated electronic patient discharge summary program leads to increased community physician and housestaff satisfaction and patient outcomes as compared to conventional discharge reports.
Detailed description
For patients hospitalized with an acute illness, the days following discharge constitute a critical period. Patients must adjust to changes in their medications, follow up with family doctors and other specialists and know what symptoms should prompt a return to hospital. The community physicians who follow them rely on information from their hospitalization to facilitate this transition, and provide continuity of care.
Communication between hospital and community physicians is essential to this process, and has traditionally been accomplished by a dictated discharge summary. Previous studies have shown that while dictated discharge summaries can be inaccurate, incomplete, or untimely, computer generated summaries are produced more quickly and accurately. Moreover, database-generated discharge summaries are preferred by physicians in the community.
We have designed a web-based computer program with quality assurance features that automatically generates timely discharge summaries. We aim to study this program over a 2 month period on our general medicine unit by means of a randomized controlled trial. Our hypothesis is that community physicians will prefer the computer generated summaries, over the standard dictated summaries. If effective, our system could be implemented more widely, and would stand to improve communication with community physicians, continuity of care, and patient safety.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| eDischarge | Experimental | Other: Electronic discharge summary systemThe eDischarge arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use the electronic discharge summary program. |
| Traditional | No intervention | –The traditional arm will consist of two teams on the General Internal Medicine ward at St. Michael's Hospital who have been randomly assigned to use "traditional," dictated discharge summaries. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Hospitalization on General Internal Medicine ward at St. Michael's Hospital
Key exclusion criteria (3 listed)
- Transfer to another service
- Death during admission
- Remains in hospital past dates specified in study protocol
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Electronic discharge summary systemThe customized electronic discharge summary program will be used to generate patient discharge summaries. | Other | eDischarge |
Primary outcome
Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Time frame: Satisfaction score assessment form to be sent one week after patient's discharge from hospital. If form is not returned in 14 days, a reminder and second form will be sent.
6 secondary outcomes
St. Michael's Hospital housestaff satisfaction from satisfaction score assessment form with 100-mm visual analogue scale
Time frame: Housestaff will fill out form upon completion of the rotation during which the study has been performed
Completion of specialist outpatient workups at St. Michael's Hospital recommended during course of hospitalization
Time frame: Within the first 30 days of patient's discharge from hospital
Patient visits to Emergency Room at St. Michael's Hospital
Time frame: Within the first 30 days after patient's discharge from hospital
Patient/proxy care transition assessment through the use of the CTM-3.
Time frame: Phone call made to patient or proxy one week after discharge. If patient/proxy is not reached, follow up calls will be made daily until patient/proxy is reached.
Prescribing errors as assessed by comparing discharge summary to inpatient record
Time frame: Upon discharge
Patient readmissions to St. Michael's Hospital
Time frame: Within 30 days of discharge
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Apr 2010.
- Background: PubMed 10065073van Walraven C, Laupacis A, Seth R, Wells G. Dictated versus database-generated discharge summaries: a randomized clinical trial. CMAJ. 1999 Feb 9;160(3):319-26.
- Background: PubMed 11929504van Walraven C, Seth R, Austin PC, Laupacis A. Effect of discharge summary availability during post-discharge visits on hospital readmission. J Gen Intern Med. 2002 Mar;17(3):186-92. doi: 10.1046/j.1525-1497.2002.10741.x.
- Background: PubMed 17327525Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007 Feb 28;297(8):831-41. doi: 10.1001/jama.297.8.831.
- Results publication: PubMed 19609623Maslove DM, Leiter RE, Griesman J, Arnott C, Mourad O, Chow CM, Bell CM. Electronic versus dictated hospital discharge summaries: a randomized controlled trial. J Gen Intern Med. 2009 Sep;24(9):995-1001. doi: 10.1007/s11606-009-1053-2. Epub 2009 Jul 16.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David M Maslove, MD principal investigator
Unity Health Toronto
Chaim M Bell, MD, PhD, FRCPC principal investigator
St. Michael's Hospital; University of Toronto
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Electronic discharge summary system in people with Patient Discharge and Continuity of Patient Care, run by Unity Health Toronto at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Apr 2010. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale (time frame: Satisfaction score assessment form to be sent one week after patient's discharge from hospital. If form is not returned in 14 days, a reminder and second form will be sent.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00670865, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Apr 2010.