The Good and The Bad of Current Discharge Summaries

At the CICC, we use a "Design Thinking" approach as we carry out our projects. Some interesting research techniques we have used to enrich our understanding of the patient experience at discharge and once they get home are patient experience mapping and cultural probes.

Different from process mapping, patient experience mapping does not only map what happened to the patient during discharge, but also what they were thinking and feeling. What was the experience like for them? What were the pain points?

To learn about what it was like for patients once they got home, we provided them with a journal and a camera to document their experience.

What we learned:

- There are a lot of players in the discharge process and there aren't clearly defined roles.

- Physicians are not well educated on the resources existing in the community.

- Patients are extremely overwhelmed when they get home form the hospital.

- The presence of family and friends makes a big difference.

The discharge summaries currently issued by hospitals are often dense in information, involve heavy use of technical language, and are meant primarily as a tool for hospital to primary care provider communication.

When we reviewed the literature and spoke to patients, we heard both good and bad:

The Good:

- When patients get the summary, they keep it.

- They use it to Google things about their condition or share it with friends.

- They give it to their family doctor. 

- Surgery departments often have very good discharge information packages and they often exist in many languages. They prepare patients for what to expect when they get home.

The Bad:

- Often important information is missing or inconsistent from what happened.

- Often patients do not have a summary given to them before they leave the hospital. If the discharge information is only given verbally, patients do not remember it.

- Often, the patient’s family doctor does not receive the summary in a timely fashion or at all.

- The language used on the summaries is not intelligible to patients.

- Often summaries are put together by someone who is not familiar with the patient.

Above all, patients feel that they would benefit from a ‘patient’ version of the discharge summary. What do you think? What do you do with your discharge summaries? Share your thoughts with us!

Stay tuned to hear more about a design event we are holding on February 13th, where patients and providers will come together to design patient oriented discharge summaries. To get involved, contact Shoshana at shoshana.hahn-goldberg@uhn.ca.