Transfer of care of postsurgical patients from hospital to the community setting: cross-sectional survey of primary care physicians

Navjeet K Uppal; David Eisen; Jeff Weissberger; Roy J Wyman; David R Urbach; Chaim M Bell

doi:10.1016/j.amjsurg.2015.03.006

Transfer of care of postsurgical patients from hospital to the community setting: cross-sectional survey of primary care physicians

Am J Surg. 2015 Oct;210(4):778-82. doi: 10.1016/j.amjsurg.2015.03.006. Epub 2015 May 14.

Authors

Navjeet K Uppal¹, David Eisen², Jeff Weissberger³, Roy J Wyman⁴, David R Urbach⁵, Chaim M Bell⁶

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Department of Family and Community Medicine, North York General Hospital, Toronto, Ontario, Canada.
³ Department of Family and Community Medicine, Markham Stouffville Hospital, Markham, Ontario, Canada.
⁴ Department of Family and Community Medicine, Toronto East General Hospital, Toronto, Ontario, Canada.
⁵ Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁶ Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: cbell@mtsinai.on.ca.

PMID: 26077334
DOI: 10.1016/j.amjsurg.2015.03.006

Abstract

Background: Postsurgical management is often delegated to family physicians once patients are discharged from hospital, but management of such patients may not be effectively communicated. We examined transfer of care of postsurgical patients by surveying family physicians.

Methods: An electronic, self-administered survey was administered from November 2012 to March 2014 to family physicians affiliated with 4 academic and community hospitals in Toronto, Canada.

Results: A total of 109 of 589 (19% response rate) family physicians completed the survey. The majority (76%) did not believe that the current transfer of care process was adequate. Uncertainty regarding management resulted in one or more adverse patient events for over half of respondents (62%).

Conclusions: A discrepancy exists between what family physicians desire to have included in transfer tools and the frequency with which these variables are included. Family physicians believe that the current process of transfer of care for postsurgical patients is inadequate and may contribute to adverse events.

Keywords: Discharge summaries; Quality improvement; Transition of care.

MeSH terms

Attitude of Health Personnel*
Canada
Communication
Community Health Services*
Cross-Sectional Studies
Humans
Patient Discharge*
Patient Transfer / organization & administration*
Postoperative Care*
Primary Health Care*
Surveys and Questionnaires