In 1999, the Institute of Medicine published facts about medical errors in health care. It demanded review and calls for healthcare transformation, focusing on quality improvement and systematic change.
The study focused on developing a care model to reduce the chances of preventable errors in the complex multidisciplinary care of haematology inpatients during discharge.
We developed an interactive, multidisciplinary, structured discharge process. Multiple focus groups were studied to identify strengths and gaps. We compared patients’ outcomes by pre-post study design after implementing the checklist in June 2014 (n = 41). A historical group of patients admitted to haematology for chemotherapy 1 year earlier in June 2013 (n = 42).
In June 2014, 100% of patients received pegfilgrastim, while 88% in June 2013 (P = .02). Antiemetic prescriptions after chemotherapy enhanced from 40% (June 2013) to 70% (June 2014; P = .004).
Two areas did not show improvement:
- number of readmissions (12 v 21; P = .26)
- number of telephone calls after discharge (nine each for June 2013 and 2014; P = 1.0).
A systematic approach to hospital discharges improved medication reconciliation, supportive care, and follow-up appointments is a must. It is considered mandatory for the haematology fellow from a timeline perspective to ensure the checklist is completed for all patients discharged. Designing a systematic approach to hospital discharges can improve and act as a model for other inpatient wards.
Ref: https://ascopubs.org/doi/full/10.1200/JOP.2015.005785
