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Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes.
Then, the responsible physician will be informed about the incomplete discharge summary.
Delayed or incomplete discharge summaries have been shown to affect follow-up management in almost one quarter of cases [ 20].
Within the UK, it has been suggested that incomplete discharge communication, including incomplete medication information, can lead to preventable readmissions [ 12].
In the observational study conducted by Witherington et al., in which the frequency of incomplete discharge information was assessed in emergency department users, approximately two-thirds of all discharge documents were incomplete with regards to changes in medication [ 14].
4 7 9 Fragmented transitions can arise from a multitude of factors at the system (eg, lack of formal institutional relationships), provider (eg, incomplete discharge summaries) and patient (eg, transportation concerns) level.
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We excluded patients who could not be reached at follow-up, especially those living abroad, refusals and cases with missing values for creatinine or hemoglobin, as well as subjects with incomplete coded discharge information.
The overall SSI rate in our study was lower than the rate reported recently from the CDC. 10 This may be because of incomplete post discharge surveillance, 28, 30 prolonged used of antibiotic prophylaxis beyond the current guideline, 34, 35 or because of less severity ill among surgical patients in Thailand than those in the US.
I find the whole thing incredible the length of time it takes; it's just been horrendous, waiting weeks to see a consultant to be told 'I don't know why you've been referred to me'…it can make you feel very insignificant"; 18 Inaccuracy, for example, incomplete hospital discharge information.
Similarly, in a qualitative study evaluating a quality improvement initiative to improve in-patient postnatal care and processes to transfer women home, midwives providing postnatal care at home reported their first home visit taking longer as a consequence of incomplete hospital discharge notes [ 27].
We do not, however, expect the post-discharge surveillance to be less complete in the last part of our study period and incomplete post-discharge surveillance therefore cannot explain the decreasing SSI rates we found after implementation of the surveillance system.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com