Evaluation of deficiencies in current discharge summaries for dialysis patients in Canada

Figures & data

Table 1 Nephrologist perceptions of discharge information transfer and quality

	N (%)
How is discharge information most often conveyed between the discharging hospital and your dialysis unit?
Discharge summary	8 (38)
Handwritten note	6 (28)
In person	3 (14)
No communication	1(5)
None required	1(5)
Telephone conversation	1(5)
Is the current process of transferring discharge information adequate?
Yes	8 (38)
No	13 (62)
In the past year, how many adverse events or near misses can you attribute to inadequate transfer of discharge information?
0	5 (24)
1–4	13 (62)
5–9	2 (9)
>10	1 (5)
Would it be worthwhile to have dialysis-specific information contained within discharge summaries?
Yes	17 (81)
No	4 (19)
Would you be willing to participate in the creation of a dialysis-specific portion of the discharge summary for hospitalized dialysis patients?
Yes	19 (91)
No	2 (9)

Table 2 Nephrologist perceptions of information that should be included on discharge summaries

Discharge summary element	Always, n (%)	Sometimes, n (%)	Never, n (%)
Problem that led to hospitalization	20 (95)	1 (5)	0 (0)
Key findings and test results	16 (76)	5 (24)	0 (0)
Final diagnoses (primary and secondary)	21 (100)	0 (0)	0 (0)
Brief hospital course	9 (43)	11 (52)	1 (5)
Condition at discharge	13 (62)	7 (33)	1 (5)
Discharge destination	12 (57)	9 (43)	0 (0)
Medications at discharge	21 (100)	0 (0)	0 (0)
Follow-up appointments and proposed management plan	20 (95)	1 (5)	0 (0)
Anticipated problems and suggested interventions	7 (33)	13 (62)	1 (5)
Pending laboratory work and tests	10 (48)	11 (52)	0 (0)
Recommendations of subspecialty consultants	11 (52)	8 (38)	2 (10)
Documentation of patient education	0 (0)	19 (91)	2 (10)
Name and 24-hour telephone number for hospital physician	5 (24)	9 (43)	7 (33)

Table 3 Nephrologist perceptions of important dialysis-specific information that should be contained within discharge summaries

Dialysis-specific information	Essential, n (%)	Nice to know, n (%)	Unnecessary, n (%)
Modifications to dialysis prescription	17 (81)	4 (19)	0 (0)
Modifications to target weight	16 (76)	5 (24)	0 (0)
Modifications to erythropoietic stimulating agent dose	14 (66)	6 (29)	1 (5)
Modifications to phosphate binder prescription	12 (57)	8 (38)	1 (5)
Modifications/Complications to vascular access, eg, new line, access thrombosis, access declotting, etc.	18 (86)	8 = 3 (14)	0 (0)
Receipt of blood transfusion	7 (33)	13 (62)	1 (5)
Receipt of intravenous iron	4 (19)	13 (62)	4 (19)
Episodes of volume overload during hospitalization	4 (19)	12 (57)	5 (24)
Initiation of antibiotics for peritonitis (including duration of antibiotics)	20 (95)	1 (5)	0 (0)
Initiation of antibiotics for line sepsis/exit-site infection (including duration of antibiotics)	20 (95)	1 (5)	0 (0)
Culture results (peritoneal/blood/exit site)	14 (67)	6 (29)	1 (5)