Are your patients being discharged safely?
Why this is important
In many trusts today the discharge process is a cause of major concern with a poorly defined and inconsistent process compromising the clinical care of patients and sometimes even leading to major patient safety incidents. Typically the discharge process fails to get vital information to GPs in a timely manner. Such information needs to include diagnosis, test results, treatment received and procedures performed and new or altered medication. All too often this information is lost, delayed or delivered incomplete or with illegible hand written notes. Without it GPs and community clinicians have to waste time calling around to get essential information and in some cases major patient safety issues arise which result in patients needing to be re-admitted to hospital. Clearly such a situation represents an unacceptable risk to patients and is a waste of valuable NHS resources.
The problems arise because the process for creating discharge summaries is often a manual operation, handled differently by each department, duplicating time and effort with processes prone to errors and time delays. Patient demographics and diagnosis are often entered as free text or missed out altogether. Accuracy and timely creation of forms are totally dependent on the availability of patient case notes and the number of staff or departments involved to complete the process. Once created, the discharge summary is not tracked or guaranteed to reach its destination, often arriving at the GP practice several weeks later and sometimes not at all.
With the changing shape of the NHS, the concerns regarding discharge information are becoming heightened. With Choose and Book (CaB), GPs are dealing with an increasing number of hospitals and independent healthcare providers. In this environment previous informal routes to gathering extra information will no be sufficient. There are also signs that Primary Care Trusts (PCTs) are starting to take the issue seriously with some of them using discharge summaries to validate claims under the Payment by Results (PbR) system and refusing to pay where satisfactory summaries are not being produced.
To download the full version of this paper click below:
PatientDischargeSummaryJune2007.pdf