To improve neurology inpatient discharge summaries by creating a template that is easier for inpatient providers to complete, clearer for outpatient providers to read, and ensures that critical information is consistently captured.

Discharge summaries are essential for continuity of care but are often inefficient for both writers and readers. Inpatient clinicians report that they are time-consuming and detract from direct patient care, while outpatient clinicians describe them as lengthy and disorganized, with key information often difficult to locate.

A five-question pre-survey of NYU Neurology outpatient providers identified priorities for improvement. A new discharge summary template emphasizing the most valued elements—actionable follow-up instructions, medication changes with justification, and discharge diagnoses—was developed. The template underwent multiple iterations using the Plan-Do-Study-Act (PDSA) framework, incorporating feedback from both inpatient and outpatient providers. Metrics included clarity, organization, ease of locating information, and overall user preference compared with the existing template.

In PDSA Cycle 1, sections were reordered to reflect outpatient priorities, and an appendix was added for detailed hospital course documentation, improving clarity and flow; 75% of respondents preferred this version. Cycle 2 streamlined the medication table, eliminated redundancies, and added a dedicated “Outpatient Providers/Appointments” section to highlight follow-up plans. In Cycle 3, full radiology reports were moved to the appendix, and instead of a manually typed discharge medication list, readers were directed to the Epic-generated after-visit summary, which serves as the definitive reconciled medication record. This version was preferred by 88.7% of providers. Cycle 4 incorporated inpatient provider feedback, which was overall favorable, and resulted in minor wording refinements prior to department-wide implementation.

Iterative PDSA cycles improved the usability and efficiency of neurology discharge summaries. The updated template highlights actionable items, minimizes redundancy, and strengthens communication between inpatient and outpatient providers. Ongoing feedback will ensure sustainability and consistent adoption.