Discharge documentation improvement project: a pilot study.
BACKGROUND
Discharge summaries remain a critical communication tool with primary care physicians. In a previous study of over 200 general medicine discharge summaries, we demonstrated that only 50% contain information regarding the indication and follow up required of any medicine changes on discharge.


OBJECTIVE
In this follow up pilot study, we assess the role of feedback and token incentives in improving discharge documentation.


METHODS
Over a 14-week period, we randomly audited a selection of discharge summaries on a fortnightly basis. The results of these audits were fed back to the junior medical staff who compiled these summaries. If over 80% of the audited discharge summaries adequately documented the indication, with required follow up for new medication changes, junior doctors were provided with a token, non-monetary incentive for their efforts. At the end of the study period, we then conducted a survey of the junior doctors involved and collected feedback regarding their impressions of the study.


RESULTS
Over the study period, 722 discharge summaries were completed and eligible for analysis. Over this time, mean appropriate documentation regarding medicine indication improved by 32%, and follow-up documentation improved by 10%. Overall, the participants felt the interventions were beneficial and that they should be continued beyond the study period.


CONCLUSIONS
Education coupled with regular feedback and non-monetary incentives can potentially lead to improvements in the quality of discharge summaries.
Joondalup Health Campus.
B
http://orcid.org/0000-0002-1098-2242
B
Tan
Sir Charles Gairdner Hospital, Western Australia, Australia.
B
B
Mulo
Department of General Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
M
M
Skinner
D001315:Australia / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000592:standards*; D004282:Documentation / Q000379:methods* / Q000706:statistics & numerical data; D057286:Electronic Health Records; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D008485:Medical Audit; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000592:standards*; D011787:Quality of Health Care
aftercare; communication; continuity of patient care; discharge summary; medication safety; quality improvement