Rethinking the discharge summary: a focus on handoff communication. A systematic literature review and narrative synthesis on the risks of medical discharge letters for patients’ safety. Schwarz C.M., Hoffmann M., Schwarz P., et al. Comprehensive quality of discharge summaries at an academic medical center. Horwitz L.I., Jenq G.Y., Brewster U.C., Chen C., Kanade S., van Ness P.H., Araujo K.L.B., Ziaeian B., Moriarty J.P., Fogerty R.L., Krumholz H.M. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation. Grimes T.C., Duggan C.A., Delaney T.P., Graham I.M., Conlon K.C., Deasy E., Jago-Byrne M.C., O' Brien P. Identifying drug-related problems during transition between secondary and primary care in New Zealand. Maxwell K., Harrison J., Scahill S., et al. Characterising the nature of primary care patient safety incident reports in the England and Wales National Reporting and learning system: a mixed-methods agenda-setting study for general practice. Patient safety: lessons from litigation 2004.Ĭarson-Stevens A., Hibbert P., Williams H., Evans H.P., Cooper A., Rees P., Deakin A., Shiels E., Gibson R., Butlin A., Carter B., Luff D., Parry G., Makeham M., McEnhill P., Ward H.O., Samuriwo R., Avery A., Chuter A., Donaldson L., Mayor S., Panesar S., Sheikh A., Wood F., Edwards A. A report for the Manchester Centre for healthcare management. Įsmail A., Neale, G., Elstein, M., Firth-Cozens, J., Davy, C., Vincent, C. Minding the gap: Interprofessional communication during inpatient and post discharge chasm care. Scotten M., Manos, E.L., Malicoat, A., Paolo, A.M. Interprofessional communication in healthcare: an integrative review. įoronda C., MacWilliams, B., McArthur, E. Prevalence and nature of medication errors and medication-related harm following discharge from hospital to community settings: a systematic review. Harms from discharge to primary care: mixed methods analysis of incident reports. Processing of discharge summaries in general practice: a retrospective record review. Spencer R.A., Spencer S.E.F., Rodgers S., et al. Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. Kripalani S., Jackson A.T., Schnipper J.L., Coleman E.A. While the study highlighted barriers to producing high quality discharge summaries which may be addressed through training and organisational initiatives, it also indicates a need for ongoing audit to ensure the quality of letters and so reduce patient risk at the point of hospital discharge. Conclusions The failure to uniformly implement national discharge letter guidance into practice is continuing to contribute to unsuccessful communication between hospital and general practice. Hospital clinicians identified several barriers to producing “successful” letters, including: juniors writing letters, time limitations, writing letters retrospectively from patient notes, and template restrictions. Analysis of GP comments highlighted that the overall clarity of discharge letters is important for effective and safe care transitions and that they should be relevant, concise, and comprehensible. Unexplained acronyms and jargon were identified in the majority of the sample (≥70% of letters). There were statistically significant differences between “successful” and “unsuccessful” inpatient letters (n = 375) in relation to inclusion of the following elements: reason for admission (99.1% vs 86.5%) diagnosis (97.4% vs 74.5%), medication changes (61.5% vs 48.9%) reasons for medication changes (32.1% vs 18.4%) hospital plan/actions (70.5% vs 50.4%) GP plan (69.7% vs 53.2%) information to patient (38.5% vs 24.8%) tests/procedures performed (97.0% vs 74.5%), and test/examination results (96.2% vs 77.3%). Results Fifty-three GPs participated in selecting discharge letters 46 clinicians responded to the hospital survey. Free text comments were analysed using corpus linguistics, and survey data were analysed using descriptive statistics. “diagnosis”, “GP plan”) based on relevant guidelines and standards. Letters were examined using content analysis we coded 15 features (e.g. surveying the hospital clinicians who wrote the sampled letters for their views. GPs commenting on the reasons for their letter assessment, and 3. General Practitioners (GPs) sampling discharge summaries they assessed to be “successful” or “unsuccessful” exemplars, 2. Methods Mixed methods study in West Midlands, England with three parts: 1. In the United Kingdom, although discharge summary targets on timeliness have been achieved, the quality of discharge summaries’ content remains variable. Abstract Background Sharing information about hospital care with primary care in the form of a discharge summary is essential to patient safety.
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