A Discharge Planning Template for the Electronic Medical Record Improves Scheduling of Neurology Follow-up for Comanaged Seizure Patients

objective: We examined whether the addition of a standardized discharge planning template (DPT) for the electronic medical record facilitated scheduling of outpatient neurology follow-up appointments in children hospitalized with seizures.

Methods: We reviewed medical records of patients discharged from a children’s hospital with a diagnosis of seizures between January 2012 and June 2013. The study cohort included children who were admitted to the hospitalist service with neurology service comanagement. To facilitate interdisciplinary communication around discharge planning, a DPT was added to the neurology consult note in July 2012. Multivariate regression was used to determine whether the postimplementation time period was associated with the primary outcome (scheduling of outpatient neurology follow-up before discharge).

Results: The final cohort included 300 patients, of whom 101 (34%) were discharged before implementation of the DPT, and 199 (66%) were discharged postimplementation of the DPT. The odds of having a neurology follow-up appointment scheduled before discharge was significantly higher after implementation of the DPT (adjusted odds ratio 2.8, 95% confidence interval 1.7–4.8) and for weekday as compared with weekend discharges (adjusted odds ratio 2.2, 95% confidence interval 1.2–3.9).

Conclusions: A discharge planning template for the electronic medical record can standardize the flow of discharge-related information between disciplines and may help expedite transitional care planning for hospitalized children, especially those with multiple consultants involved in their care. Given the inherent barriers to arranging outpatient services over the weekend, additional strategies may be necessary to enhance transitional care planning for patients going home over the weekend.