A Quality Improvement Project Reviewing the Quality of Information Included in Discharge Summaries Sent to General Practitioners (GPs) From a Home Treatment Team (HTT) in an Inner London Borough

Abstract

AimsTo improve the quality of the information included in discharge summaries to GPs from HTT. To gather the views of local GPs as to what constitutes a good discharge summary. To streamline the process for creating the discharge summaries by developing a proforma, incorporating the views of local GPs.Methods1.A cross sectional analysis of discharge summaries sent by HTT was performed.2.Each summary was assessed if they included certain information and the reader also made comments.3.A questionnaire was sent to local GPs asking for feedback on discharge summaries they had received.4.The information from the cross sectional analysis and questionnaire were used to create a discharge summary proforma.5.The findings and proforma were presented to the HTT. The team brainstormed further ideas which were incorporated in to the proforma.6.The proforma was sent to the team to begin using.7.The cross sectional analysis was repeated 6 weeks later.ResultsInitial cross sectional analysis:46 patients (2 excluded).25% of patients were discharged to the GP.Over 80% contained all the information required.Common issues included copy and pasting large amounts of irrelevant information, missing information, use of a lot of abbreviations with no explanation, unclear discharge medication, unclear discharge plans and not specifying who would prescribe.GP questionnaire:8 respondents. All GPs felt that they would want a brief summary of treatment, discharge medication (with any changes highlighted) and a plan with actions for the GP. They also felt that details of follow up with contact details for the community team would be useful. Brevity was mentioned as being of key importance, as was explaining abbreviations.Second cross sectional analysis:31 patients (6 excluded).8% of patients were discharged to the GP.12% of summaries had fully utilised the proforma and a further 16% had partially utilised it. With regards to the summaries not using the proforma the results were variable. The summaries which either fully or partially used the proforma covered all information screened for and were noted to be informative and easy to read.ConclusionA discharge summary proforma created using direct GP feedback is a useful tool to cover all the relevant information however the uptake of use of the proforma was poor. The reasons for the poor uptake would benefit from further assessment with a view to improving it further.