Improving communication between hospital and community physicians -: Feasibility study of a handwritten, faxed hospital discharge summary

OBJECTIVE To assess the timing, legibility, and completeness of handwritten, fared hospital discharge summaries as judged by family physicians and to obtain their opinion on the information categories on a standardized discharge summary form. DESIGN Fax survey of physicians for consecutive patients discharged from hospital over 8 weeks. SETTING Three wards in a tertiary care teaching hospital. PARTICIPANTS One hundred two family physicians and general practitioners practising in Hamilton, Ont. MAIN OUTCOME MEASURES Proportions of summaries that were received, received within 48 hours of discharge, legible, and complete; types of information missing from incomplete summaries; proportion of physicians satisfied with the information categories. RESULTS Of 271 consecutive patient discharges, 195 (72%) were eligible for study. Among those ineligible, 22 patients (8%) did not have a family doctor identified on their hospital records. Among records that did have a family physician identified, fax numbers were unavailable or unknown for 54 physicians (20%). One hundred two physicians completed 166 discharge summary assessments for a response rate of 85% (166/195). By 3 weeks after discharge, 138 discharge summaries (83%) had been received by patients' family doctors. Among those received, 86% were received within 48 hours of discharge; 92% were legible; and 88% were complete. Hospital doctors' signatures, patients' diagnoses, and follow-up plans were most frequently missing. Ninety-five percent of physicians were satisfied with the information categories included on the standardized form. CONCLUSIONS Handwritten, fared hospital discharge summaries were acceptable to family physicians for most patients. Criteria are needed for determining which patients require both handwritten and dictated discharge summaries.