Bansard Mathieu, Clanet Romain, Raginel Thibaut
Sante Publique. 2017 Mar 6;29(1):57-70.
Background: Communication between general practitioners (GPs) and hospitals is a weak point of the French health system. Unfortunately, hospital discharge documents, a keypoint for healthcare safety and efficiency, tend to be poorly defined. This study aimed to propose standardised and logical templates for discharge letters (DL) and discharge summaries (DS) with particular attention to GPs’ needs.Methods: A Delphi methodology was conducted on the findings of a systematic review of the international literature. We recruited 28 experts including producers (hospital physicians and interns), recipients (GPs, head of the medical information department, patient representatives), and other professionals using discharge documents (representative of regional health administration for inspection and control, jurist, pharmacists).Results: A consensus was reached after two rounds of consultation. According to the experts, DS should ideally be available on the last day of hospitalization, but this is rarely possible. DL have therefore become the most important document for GPs. Two standardised and logical templates were submitted to the experts for validation. The templates were considered to be pertinent by the experts and were perceived as improving several key points such as writing and reading speed, communication between hospitals and community practitioners or safety of healthcare after discharge from hospital.Conclusion: DL and DS templates will be tested in pilot hospitals by an impact study.
全科医生(GP)与医院之间的沟通是法国医疗系统的一个薄弱环节。不幸的是,作为医疗安全和效率关键点的医院出院文件,其定义往往不够明确。本研究旨在提出标准化且合乎逻辑的出院信(DL)和出院小结(DS)模板,尤其关注全科医生的需求。
对国际文献的系统综述结果采用德尔菲法。我们招募了28位专家,包括编制者(医院医生和实习生)、接收者(全科医生、医疗信息部门负责人、患者代表)以及其他使用出院文件的专业人员(负责检查和控制的地区卫生行政部门代表、法学家、药剂师)。
经过两轮咨询达成了共识。专家们认为,理想情况下出院小结应在住院的最后一天提供,但这很少能实现。因此,出院信已成为全科医生最重要的文件。提交了两个标准化且合乎逻辑的模板供专家验证。专家们认为这些模板具有相关性,并认为它们改善了几个关键点,如书写和阅读速度、医院与社区医生之间的沟通或出院后医疗保健的安全性。
出院信和出院小结模板将通过一项影响研究在试点医院进行测试。