Clinical question: Is a delay in completing the hospital discharge summary associated with hospital readmissions?
Background: Inpatient discharge summaries serve as a communication tool for future care providers. Previous studies have shown a mixed impact on the speed of discharge summaries on hospital readmissions.
Study the design: Retrospective cohort study.
Setting: Adult medical patients at Johns Hopkins University Hospital in Baltimore.
Synopsis: The study authors looked at the time from hospital discharge to completion of the discharge summary of 87,994 hospitalizations to assess whether a delay increased the chances of hospital readmission. Of these hospitalizations, 14,248 patients (16.2%) were readmitted within 30 days of discharge. There was a statistically significant adjusted odds ratio of 1.09 (P = 0.001) for readmission associated with discharge summaries completed more than three days after discharge.
The main advantage of the study is that the investigators looked at a large number of hospitalizations. The main limitation is that deaths or admissions to other hospitals within 30 days of discharge have not been measured.
At the end of the line : Completing a discharge summary within three days of discharge can reduce the risk of readmission within 30 days.
Quote: Hoyer EH, Odonkor CA, Bhatia SN, Leung C, Deutschendorf A, Brotman DJ. Association between days to complete inpatient discharge summaries with all pay hospital readmissions in Maryland [published online ahead of print February 23, 2016]. J Hosp Med. doi: 10.1002 / jhm.2556
Effectiveness of rapid response teams
A meta-analysis of 30 eligible studies assessing the impact of Rapid Response Teams (RRTs) from 2000 to 2016 found that RRTs are effective in reducing both in-hospital cardiac arrest and in-hospital mortality.
Quote: Solomon RS, Corwin GS, Barclay DC, Quddusi SF, Dannenberg MD. Effectiveness of rapid response teams on hospital cardiopulmonary arrest and mortality rates: a systematic review and meta-analysis [published online ahead of print Febraury 1, 2016]. J Hosp Med. doi: 10.1002 / jhm.2554.