Improving Patient Experience and Discharge Readiness in Acute Stroke Care Through a Patient-Oriented Discharge Summary: A Two-Cycle Quality Improvement Study.

Abstract

Patient-reported experience measures (PREM) capture critical aspects of stroke care quality that are not typically reflected in conventional clinical outcomes, particularly during care transition. This quality improvement initiative sought to incorporate PREM into standard acute stroke care and assess the impact of a Patient-Oriented Discharge Summary (PODS) on patient experience and discharge readiness. Employing a two-cycle Plan-Do-Study-Act methodology, a stroke-specific patient experience survey was developed and administered at discharge to patients admitted with stroke or transient ischemic attack (TIA) at Health Sciences North, Sudbury, Ontario. Baseline findings identified experience-related deficiencies despite high overall satisfaction, notably in discharge preparedness, shared decision-making, and information clarity. A PODS-based discharge intervention was implemented and evaluated using defect and top-box analyses. Post-implementation, overall defect rates significantly decreased, and top-box performance improved across all experience domains, most notably in the understanding of the condition and readiness for discharge. These findings indicate that systematic measurement of patient experience, coupled with structured discharge communication, can substantially enhance care transitions and bolster the quality and safety of acute stroke services.