1190 QUALITY IMPROVEMENT PROJECT ON MEDICAL DISCHARGE LETTERS

Abstract

Abstract Introduction The aim of this quality improvement project was to assess the medical discharge letters written by medical colleagues at this trust against the guidelines set by the Royal College of Physicians. The target was to achieve at least 90% compliance across the components evaluated at the end of this project. Method This quality improvement project evaluated medical discharge letters from three medical wards. Following the application of filtering criteria, a sample size of approximately 20 patients was randomly selected for data collection. Sections that were evaluated in the discharge letter included areas of clinical summary information, investigative results, medication changes, follow-ups and GP actions. Information obtained from the letters were reported as ‘yes’, ‘no’ or ‘non-applicable’ on an Excel spreadsheet. Data collected was analysed and areas of strengths and weaknesses were identified. They were used to form action plans, following which the cycle of evaluation was repeated. Results Two cycles were carried out in this project. Issues were identified in the sections of clinical summary, documentation of blood results, medication changes and their indication, and follow-ups. Action plans such as education (leaflet, emails and education session), introduction of a discharge letter checklist and acronym expansion were used. By the end of the third round of data collection, all components achieved at least 90% compliance, with the exception of changes in regular medications and differentiation of follow-ups into booked and those which needed booking. Conclusion This project has resulted in an increase in adherence to the standards set by the College when completing medical discharge letters. Periodic evaluation will be beneficial to ensure that a high standard of compliance is consistently achieved. Sample size could be increased to improve the significance of evaluation. This study can be expanded to other specialties to increase coverage.