TH5.3 Improving the Quality of Surgical Discharge Summaries Using a Discharge Summary Checklist- A Prospective Closed Loop Audit

Abstract

Abstract Aim Discharge summaries (DS) form the mainstay of communication between primary and secondary care following inpatient episodes. Poor quality DS often leads to poor continuity of care. We aim to audit the quality of DS following admission under general surgery and improve DS by implementing a DS checklist. Methodology A prospective audit was conducted for 100 DS across 4 surgical wards (emergency and elective) between 1/1/2021 to 1/3/2021. Data collection included the clinical summary, operation details, significant investigation results and follow up plans. A DS checklist was created and introduced at junior doctor induction. A re-audit was conducted prospectively on 100 DS produced from 1/8/2021 to 1/10/2021. Results A general improvement in quality of DS is seen across different domains. In particular, operation date (76.1% vs 90.1%, p=0.019), abnormal blood test results (89% vs 97%, p=0.323), outpatient investigations (72% vs 85%, p=0.025) and their urgency (39.6% vs 43.3%, p=0.741), GP plans and actions (73% vs 81%, p=0.178) and outpatient appointments (85% vs 93%, p=0.037). Interestingly, details of clinical summary (98% vs 94%, p=0.149) and duration of venous thromboembolism (VTE) prophylaxis (99% vs 90%, p=0.005) were worse on reauditing. Conclusion The introduction of DS checklist has significantly improved the quality of documentation and instructions for primary care for most domains. This was not seen for the domain of duration of VTE prophylaxis.