title: Electronic discharge summary and prescription: improving communication between hospital and primary care.
abstract: BACKGROUND
  The discharge letter is a key component of the communication pathway between the hospital and primary care. Accuracy and timeliness of delivery are crucial to ensure continuity of patient care. Electronic discharge summaries (EDS) and prescriptions have been shown to improve quality of discharge information for general practitioners (GPs). The aim of this study was to evaluate the effect of a new EDS on GP satisfaction levels and accuracy of discharge diagnosis.
  
  
  METHODS
  A GP survey was carried out whereby semi-structured interviews were conducted with 13 GPs from three primary care centres who receive a high volume of discharge letters from the hospital. A chart review was carried out on 90 charts to compare accuracy of ICD-10 coding of Non-Consultant Hospital Doctors (NCHDs) with that of trained Hopital In-Patient Enquiry (HIPE) coders.
  
  
  RESULTS
  GP satisfaction levels were over 90 % with most aspects of the EDS, including amount of information (97 %), accuracy (95 %), GP information and follow-up (97 %) and medications (91 %). 70 % of GPs received the EDS within 2 weeks. ICD-10 coding of discharge diagnosis by NCHDs had an accuracy of 33 %, compared with 95.6 % when done by trained coders (p < 0.00001).
  
  
  CONCLUSIONS
  The introduction of the EDS and prescription has led to improved quality of timeliness of communication with primary care. It has led to a very high satisfaction rating with GPs. ICD-10 coding was found to be grossly inaccurate when carried out by NCHDs and it is more appropriate for this task to be carried out by trained coders.
authors.affiliation: Department of Surgery, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland. stephenmurphy@rcsi.ie.
authors.forename: S F
authors.initials: SF
authors.lastname: Murphy
authors.affiliation: Department of Surgery, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Lenihan
authors.affiliation: Department of Surgery, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.
authors.forename: F
authors.initials: F
authors.lastname: Orefuwa
authors.affiliation: Department of Pharmacy, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.
authors.forename: G
authors.initials: G
authors.lastname: Colohan
authors.affiliation: Hospital Inpatient Enquiry (HIPE) Department, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.
authors.forename: I
authors.initials: I
authors.lastname: Hynes
authors.affiliation: Department of Surgery, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.|Department of Surgery, National University of Ireland, Galway, Ireland.
authors.forename: C G
authors.initials: CG
authors.lastname: Collins
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care; D058005:General Practitioners / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D010351:Patient Discharge; D055656:Prescriptions / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*
keywords: Continuity of care; Discharge letter; GP satisfaction; Patient safety
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