Standardized or narrative discharge summaries: Which do family physicians prefer?

C. Van Walraven, S. M. Duke, A. L. Weinberg, P. S. Wells

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

OBJECTIVES To determine whether family physicians prefer discharge summaries in narrative or standardized format and to determine factors affecting this preference. DESIGN Mailed survey. SETTING Internal medicine ward at a teaching hospital. PARTICIPANTS Random sample of 180 family physicians practising in the Ottawa-Carleton area. Of the original sample, 20 were not family physicians and were excluded. Of the 160 physicians remaining, 126 responded for a response rate of 78.8%. INTERVENTION For a stratified random sample of patients, medical records and narrative discharge summaries were abstracted using a data acquisition form to capture essential information. Information on completed forms was transformed into standardized summaries. Physicians were sent both narrative and standardized summaries. MAIN OUTCOME MEASURE Physicians' format preference as indicated on an ordinal 7-point scale. RESULTS The standardized format was preferred with a score of 4.28 versus 3.84 for the narrative (P <.05). Responses indicated the standardized format provided information most relevant to ongoing care, with a mean score of 4.82 (95% confidence interval [CI] 4.48 to 5.15), and easier access to summary information (5.60, CI 5.30 to 5.89). The narrative summary better described patients' admission (3.54, CI 3.18 to 3.90). Preference for standardized summaries correlated with lengthier narrative summary (P <.05), shorter length of stay (P<.05), and physicians' dissatisfaction with previous summaries (P<.001). Standardized discharge summaries were significantly shorter (302 versus 619 words, P=.004) than narrative summaries. CONCLUSIONS Physicians preferred a standardized format for discharge summaries. Format preference is influenced by physician, patient, and discharge summary characteristics.

Original languageEnglish
Pages (from-to)62-69
Number of pages8
JournalCanadian Family Physician
Volume44
Issue numberJAN.
StatePublished - 1998
Externally publishedYes

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