Auto-expansion software prompting reduces abbreviation use in electronic hospital discharge letters: an observational pre- and post-intervention study.

Background: Abbreviation use remains a significant cause of miscommunication among healthcare practitioners worldwide, creating uncertainty in interpretation and leading to poorer patient outcomes. This study aimed to assess the effectiveness of implementing auto-expansion prompts to reduce abbreviation use in electronic discharge letters (eDLs).

Methods: Observational pre- and post-intervention study conducted in 2019 at a tertiary referral hospital in Western Sydney.

Participants: Junior medical officers (JMOs) in postgraduate years 1 and 2.

Intervention: The intervention consisted of an email invitation to JMOs, outlining the risks of abbreviation use in eDLs, and providing instructions on how to use auto-expand prompts for 11 commonly used abbreviations in Cerner Powerchart.

Primary outcome measure: Reduction in the frequency of use of 11 commonly used abbreviations selected for auto-expansion, measured by a 200 eDL audit pre- and post-intervention.

Secondary outcome measures: Reduction in the total number of abbreviations used and the mean number of abbreviations per eDL in the post-intervention audit compared to pre-intervention.

Results: The baseline audit identified 1668 abbreviation uses in 200 eDLs, consisting of 350 different abbreviations. In the post-intervention audit, use of the 11 auto-expand abbreviations decreased by 43.6%, with decreased frequency of use for 9 of the 11 abbreviations. Post-intervention there was a 34.4% reduction in the total number of abbreviations used, with 1093 abbreviations identified in 200 eDLs.

Conclusions: Advising JMOs to implement auto-expansion prompts for specific abbreviations, in combination with education on the risks of abbreviation use, is a cheap and effective solution to reducing abbreviation use in eDLs. This approach could significantly improve clarity of communication between hospital doctors and community healthcare professionals during patient care transition, potentially reducing medical errors.