Among the most important components of the hospital discharge summary is the section titled "Follow-up Needs for the Primary Care Physician." This contains specific "to-do's" such as "follow up blood culture results" or "check potassium level in 1 week." These items are often crucial continuations of care needed to close the loop on productive and high-quality hospitalizations. However, they are buried in the bottom of a several page-long discharge summary, making them less likely to be seen and acted on by PCP's.
For patients who are hospitalized at UCSF and follow up with PCP's on EPIC, there's a better way. Primary care follow up needs can be put in a separate section of the discharge summary - a user-friendly box - that will link directly into primary care notes using a smart phrase. Here's how it works step-by-step:
1. Create a required Primary Care Follow-up box in the inpatient Discharge activity
2. Create a smart phrase that links to the text in this box
3. Encourage PCP's to include the smart phrase in their post-hospitalization note templates
4. To-do's will automatically populate into the Assessment and Plan of primary care notes, making them more likely to be seen and completed.
This change is technically feasible, has the potential to improve patient care transitions, and requires significantly fewer clicks for PCP's, while requiring only one additional click for discharging physicians.
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