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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00670865
Other study ID # 07-364
Secondary ID
Status Completed
Phase N/A
First received April 7, 2008
Last updated April 15, 2010
Start date May 2008
Est. completion date July 2008

Study information

Verified date April 2010
Source St. Michael's Hospital, Toronto
Contact n/a
Is FDA regulated No
Health authority Canada: Ethics Review Committee
Study type Interventional

Clinical 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.


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.


Recruitment information / eligibility

Status Completed
Enrollment 209
Est. completion date July 2008
Est. primary completion date June 2008
Accepts healthy volunteers No
Gender Both
Age group N/A and older
Eligibility Inclusion Criteria:

- Hospitalization on General Internal Medicine ward at St. Michael's Hospital

Exclusion Criteria:

- Transfer to another service

- Death during admission

- Remains in hospital past dates specified in study protocol

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research


Related Conditions & MeSH terms


Intervention

Other:
Electronic discharge summary system
The customized electronic discharge summary program will be used to generate patient discharge summaries.

Locations

Country Name City State
Canada St. Michael's Hospital Toronto Ontario

Sponsors (1)

Lead Sponsor Collaborator
St. Michael's Hospital, Toronto

Country where clinical trial is conducted

Canada, 

References & Publications (4)

Kripalani 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. Review. — View Citation

Maslove 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. — View Citation

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. — View Citation

van 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. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Primary care physician satisfaction from satisfaction score assessment form with 100-mm visual analogue scale 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. No
Secondary St. Michael's Hospital housestaff satisfaction from satisfaction score assessment form with 100-mm visual analogue scale Housestaff will fill out form upon completion of the rotation during which the study has been performed No
Secondary Completion of specialist outpatient workups at St. Michael's Hospital recommended during course of hospitalization Within the first 30 days of patient's discharge from hospital No
Secondary Patient visits to Emergency Room at St. Michael's Hospital Within the first 30 days after patient's discharge from hospital No
Secondary Patient/proxy care transition assessment through the use of the CTM-3. 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. No
Secondary Prescribing errors as assessed by comparing discharge summary to inpatient record Upon discharge No
Secondary Patient readmissions to St. Michael's Hospital Within 30 days of discharge No
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