Resident Physician Utilization and Evaluation of a Novel Electronic Discharge Tool

From the 2021 HVPAA National Conference

Michelle Knees (University of Colorado), William Silkworth, Maeveen Riordan, Daniel Trierweiler, Angela Keniston, Lauren McBeth, Marisha Burden

Background

Efficient hospital discharges are critical for patient safety. Hospital discharges are complex and require multidisciplinary teams to ensure safe patient transitions. Resident physicians play an integral role on hospital teams; providing physicians-in-training with a tool to efficiently communicate with multidisciplinary discharge teams without negatively impacting their workflow may improve discharge coordination and resident satisfaction. The “Discharge Today” electronic health record (EHR) tool is one such example developed by the University of Colorado Hospital (UCH).

Objectives

  • Promote “Discharge Today” tool resident utilization
  • Evaluate the “Discharge Today” tool’s effectiveness among residents, including its ability to streamline communication

Methods

The “Discharge Today” tool is an EHR platform created to integrate with patient lists, display discharge readiness, and streamline communication at UCH. We introduced the tool to residents from October 2019 to March 2020 and August 2020 to November 2020. Data was gathered on resident utilization, interaction, and evaluation of the tool from October 2019 to February 2021. All survey data was collected via Redcap.

Results

By February 2021, 159 University of Colorado internal medicine residents actively engaged the “Discharge Today” tool. Fifty-seven of the 157 residents utilizing the tool responded to survey requests. Of those surveyed, 35 respondents used the tool regularly for coordinating hospital discharges; 66% of this group used the tool for more than half of all hospital discharges and 88% of the group felt the tool helped to facilitate workflow. Moreover, 31% of all respondents reported a reduction in the number of daily interruptions regarding patient dispositions. Finally, 37% of users felt the tool saved time during the discharge process. Only 5.7% reported an increase in workload while utilizing the tool.

Conclusions

EHR tools can be used to facilitate communication among a multidisciplinary team of social workers, care managers, therapists, nursing staff, and physicians. The discharge today tool was viewed favorably among a cohort of internal medicine residents. A reduction in the number of daily interruptions to workflow and a reduction in the amount of time spent on coordinating hospital discharges was reported. Given the increasing emphasis on supporting resident wellness, this may be an effective tool to help ease the burden placed upon physicians-in-training while also prioritizing safe and efficient discharges.

Clinical Implications

EHR systems create innovative opportunities to utilize technology to facilitate patient care. Organizing safe discharges from the hospital is a complex and time-consuming activity involving numerous interactions with a multidisciplinary team. EHR tools to facilitate discharges can save time and improve job satisfaction. The Discharge Today tool can be easily replicated within different health systems to streamline discharge communications, a process notorious for bottlenecks and delays in care. Additional research avenues should include whether length-of-stay or time-of-discharge are impacted by this tool.

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