Jul 19, 2023

Collaboration improves care for patients leaving the hospital

An older woman wearing a stethoscope sits with a younger woman in a medical office, looking at a laptop together.
By Ben Gane
Dr. Andrea Waddell
Dr. Andrea Waddell

Leaving the hospital is a moment of transition that carries significant challenges for patients and care providers. Patients may feel intimidated as they begin to manage their own care full time; providers may worry that important details of their patient’s history or treatment won’t reach future care providers.

Patient-Oriented Discharge Summaries (PODS) are documents designed to include the patient in summarizing their own treatment and future needs. PODS have been shown to have a positive impact in a variety of healthcare settings but have not been tested for mental health settings. Alongside their team, faculty members Andrea Waddell and Paul Kurdyak have published a new paper showing the surprising benefits of PODS for psychiatry patients. Dr. Waddell spoke to us and shared her insights on how PODS can help patients.

What is a patient-oriented discharge summary (PODS)?

AW: Each time a patient leaves the hospital, a discharge summary is sent to their primary care provider. A Patient-Oriented Discharge Summary, or PODS, is a document developed in collaboration with the patient that summarizes their treatment in hospital, changes in medications, and recommendations for support and follow-up.

What motivated this research?

AW: It's been shown that PODS make patients feel more comfortable when leaving the hospital and help them manage their own care more effectively. Ontario Health recognizes PODS as a best practice. While PODS have been widely used and studied in hospitals for conditions not related to mental health, CAMH was the first hospital to adapt PODS specifically for psychiatry inpatients. The aim was to test if we could create a version of PODS that works well for mental health conditions and implement it successfully.

What was the most important finding of this study, in your opinion?

AW: We were originally interested in learning whether PODS could be used successfully for psychiatry inpatient discharges. But what we discovered was even more important. When PODS were used, it helped ensure that important tasks were completed before a patient was sent home. These tasks included checking their medications, giving them written instructions for follow-up care, teaching them about their medications, and telling them how to handle any new symptoms. In other words, PODS were not just a communication tool, but helped to ensure everything was done correctly before a patient was discharged.

What changes, if any should be made based on your research findings?

AW: The use of PODS for psychiatry patients is practical and effective. Based on our findings, we recommend PODS be used in psychiatric inpatient units and specialty mental health hospitals across Ontario and beyond.

Any next steps?

AW: We are going to examine healthcare usage information to see if PODS made a difference in what happened after patients left the hospital, such as whether they went to their appointments, got their prescriptions filled, or had to go back to the hospital. I am collaborating with a team from specialty mental health hospitals in Ontario to create a PODS process specifically for those services.

What is the major take home message for the public?

AW: Leaving the hospital after treatment is a complicated process. Adapting PODS for mental health patients allows them to be involved in that process, and ultimately leads to more effective healthcare and better results.

ImPACT logo: Psychiatry articles that change treatment

ImPACT Committee includes Krista Lanctôt, Alastair Flint, Meng-Chuan Lai and Simone Vigod.

Waddell AE, Yue Y, Comrie R, Wong BM, Kurdyak PA. Effects of the Implementation of a Patient-Oriented Discharge Summary (PODS) on Pre- and Postdischarge Outcomes. Psychiatr Serv. 2023 Apr 25:appips20220309. doi: 10.1176/appi.ps.20220309. Epub ahead of print. PMID: 37096357.