Raising the bar for patient experience during care transitions in Canada: A repeated cross-sectional survey evaluating a patient-oriented discharge summary at Ontario hospitals

Abstract

AbstractBackgroundPatient experience when transitioning home from hospital is an important quality metric linked to improved patient outcomes. We evaluated the impact of a hospital-based care transition intervention, patient-oriented discharge summary (PODS), on patient experience across Ontario acute care hospitals.MethodsWe used a repeated cross-sectional study design to compare yearly positive responses to four questions centered on discharge communication from the Canadian Patient Experience Survey (2016-2020) among three hospital cohorts with various levels of PODS implementation. Logistic regression using a binomial likelihood accounting for site level clustering was used to assess continuous linear time trends among cohorts and cohort differences during the post-implementation period. This research had oversight from a public advisory group of patient and caregiver partners from across the province.Results512,288 responses were included with mean age 69 ± 14 years (females) and 61 ± 20 years (males). Compared to non-implementation hospitals, hospitals with full implementation (>50% discharges) reported higher odds for having discussed the help needed when leaving hospital (OR=1.18, 95% CI=1.02-1.37) and having received information in writing about what symptoms to look out for (OR=1.44, 95%=1.17-1.78) post-implementation. The linear time trend was also significant when comparing hospitals with full versus no implementation for having received information in writing about what symptoms to look out for (OR=1.05, 95% CI=1.01-1.09).InterpretationPODS implementation was associated with higher odds of positive patient experience, particularly for discharge planning. Further efforts should center on discharge management, specifically: understanding of medications and what to do if worried once home.