Division of Health Sciences, Primary Care, Warwick Health Sciences, University of Warwick, Coventry, UK.
Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, UK.
BMJ Open. 2017 Nov 12;7(11):e018353. doi: 10.1136/bmjopen-2017-018353.
Discharge documents are important for transferring information from hospitals to the referring clinician; in the UK and many countries, this is often the patient's general practitioner or family physician. However, patients may or may not receive their discharge letters, and whether patients should routinely receive discharge letters remains unclear.
The review will consolidate evidence on patients receiving discharge letters through the theory-driven approach of a realist review.The review will be conducted systematically and seek to explain how, why, for whom and in what contexts does this practice 'work'. The review will specifically explore whether there benefits of this practice and if so what are the important contexts for triggering the mechanisms associated with these outcome benefits. Negative effects will also be considered.Several steps will occur: devising initial rough programme theory, searching the evidence, selecting relevant documents, extracting data, synthesising and finally programme theory refinement. As the process is viewed as iterative, this cycle of steps may be repeated as many times as is necessary to reach and may not be linear.The initial programme theory will be tested and refined throughout the review process and by stakeholder involvement of National Health Service (NHS) policy makers, practitioners and service users.
Formal ethical review is not required. The resulting programme theory is anticipated to explain how the intervention of patients receiving written discharge communication may work in practice, for whom and in what contexts; this will inform best practice of patients receiving discharge communication. The review findings will be disseminated in a peer-reviewed journal and presentations and discussions with relevant organisations and stakeholders. While the review will be from the perspective of the UK NHS, its findings should be relevant to other healthcare systems.
CRD42017069863.
出院文件对于将信息从医院转交给转诊临床医生（在英国和许多国家，通常是患者的全科医生或家庭医生）非常重要。然而，患者可能会收到或不会收到他们的出院信，而且患者是否应该常规收到出院信仍不清楚。
本综述将通过真实主义综述的理论驱动方法来整合有关患者收到出院信的证据。综述将系统地进行，并试图解释这种做法“如何”、“为何”、“对谁”以及“在什么情况下”有效。综述将特别探讨这种做法是否有好处，如果有，触发与这些结果益处相关的机制的重要背景是什么。也将考虑负面效果。将进行几个步骤：设计初始粗糙方案理论、搜索证据、选择相关文件、提取数据、综合，最后是方案理论细化。由于该过程被视为迭代的，因此可能需要重复此步骤循环多次，直到达到目的，并且可能不是线性的。初始方案理论将在整个综述过程中以及通过 NHS 政策制定者、从业者和服务用户的利益相关者参与进行测试和完善。
不需要正式的伦理审查。预计最终的方案理论将解释患者接受书面出院沟通的干预措施在实践中如何、对谁以及在什么情况下有效；这将为患者接受出院沟通提供最佳实践建议。综述结果将在同行评议的期刊上发表，并与相关组织和利益相关者进行演示和讨论。虽然综述将从英国 NHS 的角度出发，但它的发现应该与其他医疗保健系统相关。
CRD42017069863。
