[Results of implementing a programme to improve the quality of the contents in hospital discharge reports in cases of heart failure]

Rev Calid Asist. 2015 Mar-Apr;30(2):64-71. doi: 10.1016/j.cali.2014.12.008. Epub 2015 Mar 5.
[Article in Spanish]

Abstract

Objectives: To analyse the information collected in hospital discharge reports (HDR) that are given to patients with a diagnosis of heart failure (HF), and demonstrate the improvement in the content of these reports after the introduction of an intervention.

Material and methods: HDR with HF as the main diagnosis issued by the Department of Internal Medicine were analysed, and the presence of the diagnosis, prognosis and therapeutic data in these HDR was compared in a sample before and after the intervention, which consisted of reporting the results of analysis of the initial sample to the physicians.

Results: A total of 651 HDR (371 pre-intervention and 280 post-intervention) were analysed. Most of the HDR (over 70%) did not include the functional class. Most of the HDR did not include information about echocardiogram performed before the hospitalization period analysed, and most of the HDR that collected this information did not determine if the HF was diastolic or systolic. In the post-intervention sample there was a lower percentage of HDR that prescribed angiotensin-converting enzyme inhibitors or angiotensin receptor blocker ii (26% vs 32%, P<.001). In 30% of the pre-intervention sample and 38% of the post-intervention sample there was indication of beta-blockers (P=.027).

Conclusions: A short discussion with the physicians responsible for patients with HF improves the inclusion of important data on the diagnosis, prognosis and treatment in the HDR.

Keywords: Alta del paciente; Continuidad de cuidados; Continuity of care; Heart failure; Insuficiencia cardiaca; Patient discharge report.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Aged, 80 and over
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Continuity of Patient Care
  • Data Accuracy
  • Diagnosis-Related Groups
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / drug therapy
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Patient Discharge / standards*
  • Patient Readmission
  • Program Evaluation
  • Quality Improvement
  • Retrospective Studies

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists