The Communication To Primary Care Physician Discussion

The Communication To Primary Care Physician Discussion

Please respond to the discussion post below

Doi: 10.1002/jhm.668- Problems After Discharge and Understanding of

Communication with their PCPs Among Hospitalized Seniors:

Design Methodology, Sampling Method, Data Collection

Telephone interviews from 114 older adults, with 64 completed two weeks after an

inpatient hospital stay, report their encounters with post-discharge problems and

primary acknowledgment of hospital stays. The study design involved enrolling

patients utilizing the University of Chicago’s Hospitalist Study, a study measuring

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patient care while in the hospital. The time frame was February 2008 until July 2008 The Communication To Primary Care Physician Discussion.

The engagement plan consisted of high-risk patients by the VES-13 by age, the self-

rate of their health and overall bodily function. These patients surveyed their primary

care providers regarding their hospital admission. Also, the tenth hospitalized patient

with a medical record number ending in number five analyzed their primary care

provider about the communication received while in the hospital. The primary provider

received a survey ensuring their knowledge of the selected patient had been

hospitalized (Aurora et al., 2010).

The interview data collection used the Atlas.5.2 (Berlin) software. A deductive

approach was reported to be used with post-discharge problems. These problems

involved missed follow-up appointments and diagnostic testing, medication and

medical errors, and increased risks of re-admissions. Any new codes were under the

constant comparative method. The coding of the interviews involved no prior

assumptions, and each one was named during the first coding process. Each interview

was an incident and compared between interviews compiling categories and themes.

(Aurora et al., 2010)The Communication To Primary Care Physician Discussion.

The collection information was analyzed using Stata 10.0 (College Station, TX)

software. The frequency and percentage of patients that reported discharged

problems and the number of primary care providers knowing the patient was in the

hospital resulted using descriptive statistics. Fisher’s exact test assessed any

associations connecting post-discharge complications and the primary care

provider’s realization of the hospitalization (Aurora et al., 2010).

Results and Implications

Patients with discharge complications consisted of forty -two percent. The most

prevalent problem was follow-up visits and testing. Many of these patients were re-

admitted to the hospital without continuous care. Medication delays were the second

most common issue (Aurora et al., 2010). Forty completed provider surveys were

conducted, with twelve providers stating they were unaware of patients being

hospitalized. There was a 67% increase in post-discharge complications in which the

primary care provider was unaware they were in the hospital, compared to 32 % with

primary providers aware of the hospital stay (Aurora et al., 2010)The Communication To Primary Care Physician Discussion.

As a result of the above study, the patient continuation of care warrants improvement.

It is critical to incorporate interventions to ensure better communication with primary

care providers about their hospitalized patients. For example, hospital-based

physicians can include direct contact within 48 hours of patients being admitted to

the hospital. One alternative is to implement specific time slots for telephone

communication with the primary care provider. When hospital-based physicians

and primary care providers employ the same electronic medical record system, direct

messaging can also communicate patient admissions (Enzinger et al., 2021).

References

Arora, V. M., Prochaska, M. L., Farnan, J. M., D’Arcy V, M. J., Schwanz, K. J., Vinci, L. M.,

Davis, A. M., Meltzer, D. O., & Johnson, J. K. (2010). Problems after discharge and

understanding of communication with their primary care physicians among

hospitalized seniors: A mixed methods study. Journal of Hospital Medicine, 5(7),

385–391. https://doi.org/10.1002/jhm.668

Enzinger, L., Dumanoir, P., Boussat, B., Couturier, P., & Francois, P. (2021). Direct phone

communication to primary care physician to plan discharge from hospital: Feasibility

and benefits. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-

021-07398-w The Communication To Primary Care Physician Discussion

Thank you for the great paper. The study by Arora et al. (2010) is informative on the need to improve communication with primary care physicians during and after discharge. The study design was a prospective mixed-methods study, which integrates elements of qualitative and quantitative research. Mixed design provides a researcher with a rigorous approach to tackle the research questions. As you have noted, the study used telephone interviews to collect data. The advantages of telephone interviews include decreased cost, enhanced interviewer safety, and the ability to reach respondents in different geographical regions (Liamputtong, 2019). A disadvantage of telephone interviews is poor connectivity, which results in a high non-response rate. The Fisher’s exact test used in the study determines the statistical significance between two categorical variables.

The study results have implications for nursing practice. Delayed and insufficient communication between PCPs and patients before discharge is a common issue and has an impact on patient health. As you have noted, there is a need for improvement in care transition through good communication and proper coordination of care between providers. The results can be used to guide a quality improvement project for direct contact with patients’ primary care physicians (PCPs) before discharge. The contact can be an arranged telephone appointment or video-calls (Munchhof et al., 2020). Another way would be through the implementation of a secure free messaging system between PCPs and hospital physicians to promote communication before and after discharge. This would entrench communication between the PCP and hospital physician before discharge as a routine practice to enhance transitional care (Zackoff et al., 2018)The Communication To Primary Care Physician Discussion. Shared electronic medical records, scripting of calls, and feedback from PCPS-hospitalists can improve information exchange.

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References

Liamputtong, P. (Ed.). (2019). Handbook of research methods in health social sciences. Singapore:: Springer.

Munchhof, A., Gruber, R., Lane, K. A., Bo, N., & Rattray, N. A. (2020). Beyond discharge summaries: communication preferences in care transitions between hospitalists and primary care providers using electronic medical records. Journal of general internal medicine, 35(6), 1789-1796.

Zackoff, M. W., Graham, C., Warrick, D., Pulda, K., Gosdin, C., Simpson, B., … & Mussman, G. M. (2018). Increasing PCP and hospital medicine physician verbal communication during hospital admissions. Hospital Pediatrics, 8(4), 220-226. The Communication To Primary Care Physician Discussion