Doctor of Nursing Practice (DNP) Projects

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Doctor of Nursing Practice

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Adult Gerontological Primary Care Nurse Practitioner (AGPCNP)

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hematology, oncology, stem cell transplant, discharge, care transitions, communication


Karen Kalmakis

DNP Project Chair

Jeungok Choi


Transitions of care are complex processes for healthcare facilities, healthcare personnel, and the patients involved. The transition from acute, inpatient care to community, outpatient-based care can be especially challenging for hematology-oncology patients and may be attributed to a lack of standardized discharge processes and poor communication between clinicians. Standardizing discharge communication was hypothesized to improve communication timeliness and completeness in a hospital-based inpatient and outpatient ambulatory cancer clinic. A QI project was conducted using an updated standardized discharge summary and EMR-based Smart Text (ST) template intervention. Communication was measured using hospital discharge data and a Healthcare Provider Communication Questionnaire (HPCQ) administered before and after implementation. Descriptive statistics was used to summarize and identify the characteristics of the captured data. Out of 92 discharges over a three-month span, 91 discharges (98.91%) utilized the updated discharge summary. In a sample of outpatient hematology-oncology healthcare providers (HCPs) (n=5), there were shifting priorities in what information was considered essential depending on the type of provider and their role. Across all communication components, there was an increase in the frequency of type of information communicated by up to 31.58%, receipt of discharge communication within two days of discharge by 23.53%, and communication completeness by 12.5%. Communication strengths and areas for improvement included similar themes of filling out the discharge summary to completion and verbal sign-out. The results of this study suggest that standardization of communication might increase timeliness and completeness of discharge information and improve patient outcomes.

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