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Poor Communication in Hospital Readmissions

Discharging and readmitting physicians communicated on only about half the patients who returned within 2 weeks.

When patients who are discharged from a hospital are readmitted, do the discharging and readmitting medical teams communicate with each other? To examine this issue, researchers at two Boston teaching hospitals surveyed residents and attending physicians about patients who required short-term readmission after being discharged from general medicine services.

Of 432 consecutive patients who were discharged and readmitted within the next 14 days, 123 had common providers on both teams, and 84 had planned readmissions; thus, 225 cases were analyzed. Discharging teams were aware that their patients had been readmitted in only 49% of cases, and communication occurred between teams in only 44% of cases. When communication did not occur, 61% of respondents believed that communication would have been beneficial.

Comment: These results won’t surprise physicians who work in systems in which hospitalist or resident-attending teams rotate every few weeks. Better communication likely would enhance quality of care: In caring for hospitalized patients, we learn valuable medical and psychosocial information that doesn’t always appear in discharge summaries. Failure to communicate also results in lost learning opportunities: We surely learn valuable lessons when we see what happens to our patients shortly after hospital discharge. Creating systems to ensure communication between discharging physicians and readmitting physicians simply makes good sense.

— Allan S. Brett, MD

Published in Journal Watch General Medicine April 2, 2009

Citation(s):

Roy CL et al. Hospital readmissions: Physician awareness and communication practices. J Gen Intern Med 2009 Mar; 24:374.

• Medline abstract (Free)