Patient Safety

Systematic Process to Determine Clinical Harm From Delayed Communication Between Primary and Secondary Healthcare

Publication Date Jun 17, 2022


Introduction: Timely written communication between primary and secondary healthcare providers is paramount to ensure effective patient care. In 2020, there was a technical issue between two interconnected electronic patient record (EPR) systems that were used by a large hospital trust and the local community partners. The trust provides healthcare to a diverse multiethnic inner-city population across three inner-city London boroughs from two extremely busy acute district general hospitals. Consequently, over a four-month period, 58,521 outpatient clinic letters were not electronically sent to general practitioners following clinic appointments. This issue affected 27.9% of the total number of outpatient clinic letters sent during this period and 42,251 individual patients. This paper describes the structure, methodological process, and outcomes of the review process established to examine the harm that may have resulted due to the delay. Methodology: Senior clinicians examined the letters following training to ensure a standardized consistent approach to the evaluation. They searched whether any actions that had been requested to be undertaken by primary care had been completed in a timely fashion. Thereafter, they indicated whether in their opinion there was any potential “predefined” harm. All letters that were identified as “potential” harm were reexamined by the leads to determine that the harm or inaction was truly accurate. The trust then contacted the patient to apologize and urgently expedite the outstanding action....


Outstanding Actions Primary Care Outpatient Clinic Letters Secondary Healthcare Providers Large Hospital Trust Electronic Patient Record Outpatient Letters Clinical Review Untoward Incidents Incidents In Future

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