Abstract
Introduction: Discharge summaries (DS) for older patients can be more complex due to an increasing life-expectancy and multiple co-morbidities. However, this is not always reflected in the quality of DS produced. It is generally agreed that good quality DS should reduce readmission and improve patient care after discharge.
Aims: Identify areas of weakness in Discharge summary V4 a on an elderly care ward at Salford Royal Hospital (SRFT) using a pre-established assessment and scoring tool. Secondary aims were to use interventions an educational session, poster (S.M.I.L.E) and acronym expansions to improve DS quality.
Methods: This prospective QIP was a three-cycle project assessing DS collected over a 2-week periods on an elderly care ward at SRFT. Phase one (n=8 DS) assessed DS any intervention. Then intervention one (a poster and educational session) was implemented and assessed in phase two (n=8), whilst phase 3 (n=12) assessed a second intervention (acronym expansions).
Results: Initial areas for improvement including safety-netting (complete in 5/8), indications for medications (started 4/6, stopped 4/5 and changed 1/3), lay language (done poorly or not at all in 3/8) and follow up information. After intervention one 7/8 DS had “good” lay language and indications for stopping/starting medications were included in 100% of DS. Phase three demonstrated indications for medication changes were not maintained however results in other areas remained largely the same.
Conclusion: Discharge summaries for aging patients are complex and further research should look at patient and relative perspectives to ascertain a patient centred approach to improving discharge summaries.