University of Twente Student Theses
Examining the timeliness of clinical discharge letters : evaluating processes for dispatching letters within 24 hours
Diermen, N. van (2024) Examining the timeliness of clinical discharge letters : evaluating processes for dispatching letters within 24 hours.
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| Abstract: | Medisch Spectrum Twente (MST) continues to face significant performance gaps among departments, particularly in achieving the 90% standard for timely discharge letters. This study aims to analyse the underlying processes that influence timely dispatch of discharge letters within 24 hours across low, middle and high scoring departments and determine factors influencing the attainment or failure to meet the 90% guideline for dispatching clinical discharge letters within 24 hours. Therefore, a mixed methods study was conducted, collecting data through surveys and semi-structured interviews. The departments included based on performance differences and teaching/non-teaching status are neurology (low scoring, teaching department), pulmonology (middle scoring, teaching department), and urology (high scoring, non-teaching department). Data analysis involved numerical conversion, median calculation, interquartile range (IQR), and Fisher’s Exact Test for P-values. Interviews were transcribed and analysed. The indicator 'dispatching clinical discharge letters within 24 hours' shows a low average of 59%. This study identified a significant association between experiences (p = 0.002), expectations (p = 0.025), and barriers (p = 0.01) and the timely dispatch of clinical discharge letters within the neurology, pulmonology and urology departments. The findings reveal that neurology, pulmonology, and urology encounter challenges in dispatching clinical letters within 24 hours. These challenges include time constraints, administrative burdens, and issues with HiX templates. Additionally, HiX does not effectively facilitate the writing of discharge letters, lacks a reminder system, and removes patients from the admission list. Neurology needs reminders in the EHR and differentiation of discharge letter urgency. Pulmonology could benefit from AI and a reminder system in HiX. Urology highlighted AI-generated summaries and modern supervision as potential facilitators. Overall, the dispatch of discharge letters will continue to pose challenges unless (potential) facilitators are implemented to streamline the process and achieve the established 90% guideline. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/100756 |
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