Standards in medical record keeping

R Mann, J Williams - Clinical medicine, 2003 - Elsevier
Medical records serve many functions but their primary purpose is to support patient care.
The RCP Health Informatics Unit (HIU) has found variability in the quality of records and …

General practitioner–hospital communications: a review of discharge summaries

S Wilson, W Ruscoe, M Chapman… - Journal of quality in …, 2001 - Wiley Online Library
The objective of this study was to examine the reliability, effectiveness, accuracy and
timeliness of hospital to general practitioner (GP) information transfer by discharge …

What is necessary for high-quality discharge summaries?

C van Walraven, E Rokosh - American Journal of Medical …, 1999 - journals.sagepub.com
The objective of this study was to determine what physicians perceive to be necessary for
high-quality discharge summaries. One-on-one surveys of 100 hospital-based physicians-in …

Evaluation of electronic discharge summaries: a comparison of documentation in electronic and handwritten discharge summaries

JL Callen, M Alderton, J McIntosh - International journal of medical …, 2008 - Elsevier
BACKGROUND: Hospital discharge summaries have traditionally been paper-based
(handwritten or dictated), and deficiencies have often been reported. On the increase is the …

Dictated versus database-generated discharge summaries: a randomized clinical trial

C Van Walraven, A Laupacis, R Seth, G Wells - Cmaj, 1999 - Can Med Assoc
BACKGROUND: Hospital discharge summaries communicate information necessary for
continuing patient care. They are most commonly generated by voice dictation and are often …

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

C Van Walraven, SM Duke, AL Weinberg… - Canadian Family …, 1998 - ncbi.nlm.nih.gov
OBJECTIVES: To determine whether family physicians prefer discharge summaries in
narrative or standardized format and to determine factors affecting this preference. DESIGN …

Audit and feedback: an intervention to improve discharge summary completion

A Dinescu, H Fernandez, JS Ross… - Journal of Hospital …, 2011 - Wiley Online Library
Discharge summaries (DS) communicate important clinical information from inpatient to
outpatient settings. Previous studies noted increased adverse events and rehospitalization …

Prospective audit of discharge summary errors

EM Macaulay, GG Cooper, J Engeset… - Journal of British …, 1996 - academic.oup.com
During an 8-month interval of prospective audit, 63 of 637 (10 per cent) vascular discharge
summaries were found to contain 94 errors. These comprised 11 (12 per cent) general …

Improving communication between hospital and community physicians. Feasibility study of a handwritten, faxed hospital discharge summary. Discharge Summary …

JM Paterson, RL Allega - Canadian Family Physician, 1999 - ncbi.nlm.nih.gov
OBJECTIVE: To assess the timing, legibility, and completeness of handwritten, faxed
hospital discharge summaries as judged by family physicians and to obtain their opinion on …

Evaluation of a computer-generated discharge summary for patients with acute coronary syndromes.

RA Archbold, K Laji, A Suliman, K Ranjadayalan… - British journal of general …, 1998 - bjgp.org
The discharge summary from hospital to community physician contributes importantly to
patient management, but deficiencies in its preparation are well documented. We sought to …