Whittington Health NHS Trust, Whittington Hospital, London, UK.
Int J Risk Saf Med. 2022;33(S1):S63-S67. doi: 10.3233/JRS-227026.
Discharge summaries (DCS) are vital in facilitating handover to community colleagues. Unfortunately, at Whittington Health, General Practitioners (GPs) found it difficult to identify relevant information in DCS, and use of medical jargon meant patients did not understand details of their admission. With this quality improvement project, the team aimed to improve DCS to enhance patient-centered care.
The aim of this quality improvement project (QIP) was to improve the quality of DCS by critiquing the ones produced within our trust and implementing various interventions.
Multiple Plan-Do-Study-Act (PDSA) cycles were completed. A multi-disciplinary meeting was conducted to identify the needs of each party in a DCS. A new template was subsequently launched. Teaching was conducted and educational leaflets were disseminated hospital-wide. Quality of written communication was audited quarterly, and evaluated against quality indicators. Problems with DCS were identified via GP and patient feedback, and these became the focus of subsequent PDSA cycles.
From March 2019 to February 2020, all the audited categories improved, with an overall improvement from 67% to 92%. We also received positive feedback from GPs.
Quality of DCS can be improved with appropriate interventions, leading to improved patient care. A similar PDSA cycle could be utilized elsewhere to achieve similar results.
出院小结（Discharge summaries，DCS）对于向社区同事交接至关重要。遗憾的是，惠廷顿卫生保健中心（Whittington Health）的全科医生（General Practitioners，GPs）发现难以从 DCS 中识别相关信息，而医学术语的使用则导致患者无法理解其入院细节。在这个质量改进项目中，团队旨在改进 DCS 以增强以患者为中心的护理。
该质量改进项目（quality improvement project，QIP）的目的是通过对我们信托机构内生成的 DCS 进行审查并实施各种干预措施，来提高 DCS 的质量。
完成了多个计划-执行-研究-行动（Plan-Do-Study-Act，PDSA）循环。召开了一次多学科会议，以确定 DCS 各方的需求。随后推出了一个新模板。在全院范围内进行了教学并发放了教育传单。每季度对书面沟通质量进行审核，并根据质量指标进行评估。通过全科医生和患者的反馈，发现了 DCS 存在的问题，这些问题成为后续 PDSA 循环的重点。
从 2019 年 3 月到 2020 年 2 月，所有审核类别均有所改善，总体从 67%提高到 92%。我们还收到了全科医生的积极反馈。
通过适当的干预措施，可以提高 DCS 的质量，从而改善患者的护理。在其他地方也可以使用类似的 PDSA 循环来取得类似的结果。
