Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care

Abstract Stress hyperglycemia (SH) is a manifestation of altered glucose metabolism in acutely ill patients which worsens outcomes and may represent a risk factor for diabetes. Continuity of care can assess this risk, which depends on quality of hospital clinical documentation. We aimed to determine...

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Autores principales:	Eric D. Moyer, Erik B. Lehman, Matthew D. Bolton, Jennifer Goldstein, Ariana R. Pichardo-Lowden
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d8dba1f44a114445992269e9979b0113
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spelling	oai:doaj.org-article:d8dba1f44a114445992269e9979b01132021-12-02T17:51:21ZLack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care10.1038/s41598-021-89945-32045-2322https://doaj.org/article/d8dba1f44a114445992269e9979b01132021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89945-3https://doaj.org/toc/2045-2322Abstract Stress hyperglycemia (SH) is a manifestation of altered glucose metabolism in acutely ill patients which worsens outcomes and may represent a risk factor for diabetes. Continuity of care can assess this risk, which depends on quality of hospital clinical documentation. We aimed to determine the incidence of SH and documentation tendencies in hospital discharge summaries and continuity notes. We retrospectively examined diagnoses during a 12-months period. A 3-months representative sample of discharge summaries and continuity clinic notes underwent manual abstraction. Over 12-months, 495 admissions had ≥ 2 blood glucose measurements ≥ 10 mmol/L (180 mg/dL), which provided a SH incidence of 3.3%. Considering other glucose states suggestive of SH, records showing ≥ 4 blood glucose measurements ≥ 7.8 mmol/L (140 mg/dL) totaled 521 admissions. The entire 3-months subset of 124 records lacked the diagnosis SH documentation in discharge summaries. Only two (1.6%) records documented SH in the narrative of hospital summaries. Documentation or assessment of SH was absent in all ambulatory continuity notes. Lack of documentation of SH contributes to lack of follow-up after discharge, representing a disruptor of optimal care. Activities focused on improving quality of hospital documentation need to be integral to the education and competency of providers within accountable health systems.Eric D. MoyerErik B. LehmanMatthew D. BoltonJennifer GoldsteinAriana R. Pichardo-LowdenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eric D. Moyer Erik B. Lehman Matthew D. Bolton Jennifer Goldstein Ariana R. Pichardo-Lowden Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
description	Abstract Stress hyperglycemia (SH) is a manifestation of altered glucose metabolism in acutely ill patients which worsens outcomes and may represent a risk factor for diabetes. Continuity of care can assess this risk, which depends on quality of hospital clinical documentation. We aimed to determine the incidence of SH and documentation tendencies in hospital discharge summaries and continuity notes. We retrospectively examined diagnoses during a 12-months period. A 3-months representative sample of discharge summaries and continuity clinic notes underwent manual abstraction. Over 12-months, 495 admissions had ≥ 2 blood glucose measurements ≥ 10 mmol/L (180 mg/dL), which provided a SH incidence of 3.3%. Considering other glucose states suggestive of SH, records showing ≥ 4 blood glucose measurements ≥ 7.8 mmol/L (140 mg/dL) totaled 521 admissions. The entire 3-months subset of 124 records lacked the diagnosis SH documentation in discharge summaries. Only two (1.6%) records documented SH in the narrative of hospital summaries. Documentation or assessment of SH was absent in all ambulatory continuity notes. Lack of documentation of SH contributes to lack of follow-up after discharge, representing a disruptor of optimal care. Activities focused on improving quality of hospital documentation need to be integral to the education and competency of providers within accountable health systems.
format	article
author	Eric D. Moyer Erik B. Lehman Matthew D. Bolton Jennifer Goldstein Ariana R. Pichardo-Lowden
author_facet	Eric D. Moyer Erik B. Lehman Matthew D. Bolton Jennifer Goldstein Ariana R. Pichardo-Lowden
author_sort	Eric D. Moyer
title	Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
title_short	Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
title_full	Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
title_fullStr	Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
title_full_unstemmed	Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
title_sort	lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d8dba1f44a114445992269e9979b0113
work_keys_str_mv	AT ericdmoyer lackofrecognitionanddocumentationofstresshyperglycemiaisadisruptorofoptimalcontinuityofcare AT erikblehman lackofrecognitionanddocumentationofstresshyperglycemiaisadisruptorofoptimalcontinuityofcare AT matthewdbolton lackofrecognitionanddocumentationofstresshyperglycemiaisadisruptorofoptimalcontinuityofcare AT jennifergoldstein lackofrecognitionanddocumentationofstresshyperglycemiaisadisruptorofoptimalcontinuityofcare AT arianarpichardolowden lackofrecognitionanddocumentationofstresshyperglycemiaisadisruptorofoptimalcontinuityofcare
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Lack of recognition and documentation of stress hyperglycemia is a disruptor of optimal continuity of care

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