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Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study.

dc.contributor.author Greer, Raquel C
dc.contributor.author Liu, Yang
dc.contributor.author Crews, Deidra C
dc.contributor.author Jaar, Bernard G
dc.contributor.author Rabb, Hamid
dc.contributor.author Boulware, L Ebony
dc.coverage.spatial England
dc.date.accessioned 2017-10-13T01:35:33Z
dc.date.available 2017-10-13T01:35:33Z
dc.date.issued 2016-08-30
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/27577888
dc.identifier 10.1186/s12913-016-1697-7
dc.identifier.uri https://hdl.handle.net/10161/15632
dc.description.abstract BACKGROUND: High quality hospital discharge communications about acute kidney injury (AKI) could facilitate continuity of care after hospital transitions and reduce patients' post-hospitalization health risks. METHODS: We characterized the presence and quality (10 elements) of written hospital discharge communications (physician discharge summaries and patient instructions) for patients hospitalized with AKI at a single institution in 2012 through medical record review. RESULTS: In 75 randomly selected hospitalized patients with AKI, fewer than half of physician discharge summaries and patient instructions documented the presence (n = 33, 44 % and n = 10, 13 %, respectively), cause (n = 32, 43 % and n = 1, 1 %, respectively), or course of AKI (n = 23, 31 %, discharge summary only) during hospitalization. Few provided recommendations for treatment and/or observation specific to AKI (n = 11, 15 and 6, 8 % respectively). In multivariable analyses, discharge communications containing information about AKI were most prevalent among patients with AKI Stage 3, followed by patients with Stage 2 and Stage 1 (adjusted percentages (AP) [95 % CI]: 84 % [39-98 %], 43 % [11-82 %], and 24 % [reference], respectively; p trend = 0.008). AKI discharge communications were also more prevalent among patients with known chronic kidney disease (CKD) versus those without (AP [95 % CI]: 92 % [51-99 %] versus 39 % [reference], respectively, p = 0.02) and among patients discharged from medical versus surgical services (AP [95 % CI]: 73 % [33-93 %] versus 23 % [reference], respectively, p = 0.01). Communications featured 4 median quality elements. Quality elements were greater in communications for patients with more severe AKI (Stage 3 (number of additional quality elements (β) [95 % CI]: 2.29 [0.87-3.72]), Stage 2 (β [95 % CI]: 0.62 [-0.65-1.90]) and Stage 1 (reference); p for trend = 0.002). CONCLUSIONS: Few hospital discharge communications in AKI patients described AKI or provided recommendations for AKI care. Improvements in the quality of hospital discharge communications to improve care transitions of patients with AKI are needed.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC Health Serv Res
dc.relation.isversionof 10.1186/s12913-016-1697-7
dc.subject Acute kidney injury
dc.subject Hospitalizations
dc.subject Transitions of care
dc.title Hospital discharge communications during care transitions for patients with acute kidney injury: a cross-sectional study.
dc.type Journal article
duke.contributor.id Boulware, L Ebony|0078608
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/27577888
pubs.begin-page 449
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Community and Family Medicine
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 16
dc.identifier.eissn 1472-6963
duke.contributor.orcid Boulware, L Ebony|0000-0002-8650-4212


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