Below is the outline – PLEASE READ ALL and EVERY point …
Also please include any relevant study findings from other papers to help back up points.
Issue: Inpatients in a hospital setting are leaving/being discharged prior to receiving their paper work
Background: After patients are deemed medically fit for discharge, patients leave hospital without waiting for a completed discharge summary. There are many reasons for this, mainly because patients dont want to wait any longer, especially if they already have all their medications ready/at home (why should they wait if the only outstanding job is paperwork?)
This issue has been ongoing for years I think and has been “resolved” by posting the paper work to the address which raises a few issues:
1. Once patient has left, there is no gaurantee that the paper will be completed, this leaves a stack of folders which is not completed
2. Following on from point 2- this means the visit of that patient will potentially not be recorded anywhere. GPs will not be updated and important information will be missed/not communicated between healthcare professionals. Therefore if in future that patient represents to hospital for whichever reason, there will be a missing information which may be important/linked with the new admission!
3. Documentation at the time of events is important !
4. Some letters need to be prepared earlier on as the medications written on the summary takes time to be transferred up to wards ie. those patients needing controlled drugs on discharge, these medications takes longer for pharmacists to arrange the medication package.
Some reasons as to why it may be difficult to prepare discharge letters on time: (PLEASE IF YOU FIND STUDIES FROM LITERATURE REVIEW INCLUDE IT TO BACK UP POINTS)
1. Main reason- Due to staff shortage or very busy days admin work becomes less of a priority.
2. Sometimes not knowing the patient’s story/background/reason for discharge will mean doctors will have to spend more time on looking back to previous documentations to piece together the story.
3. Some junior doctors may not understand the importance of ensuring discharge letters are done (main importance is so that all patient have every clinical encounter documented)
So what did we do?
We wanted to increase the motivation of staff to prioritise discharge summaries and complete them in a timely manner.
We put all the names of the team leaders on a board in the doctors office.
Those team leaders who complete the most discharge summaries win a prize
The main aim is not to “name and shame” but we found this helps increase some “light hearted competition”
We aim to look at the % of patients discharged with a completed EDS on a random day though the month and then scoring the team leader then to present the results at the end of each month.
All team leaders will be informed via email on their teams performances and the winners get a prize.
Reason: A measure taken to improve the completion ares (along with not allowing discharged to happened without a completed letter)/
Result from first cycle:
8 audited only 4 had 100% completion rate.
Next cycle due next month
If you need any further information please let me know!
Please remember I would prefer if you include some reference to other literature to back up points