The elements identified from the literature will be used as a basis for a subsequent study designed to formalize discharge summaries for GPs.

Objectives Acute triage is needed to prioritize care and achieve optimal resource allocation in busy emergency departments. The main objective is to compare the FRench Emergency Nurse Classification in Hospital scale (FRENCH) to the American scale Emergency Severity Index (ESI). Secondary objectives are to compare for each scale the over and under-triage, the triage matching to the gold standard and the inter-individual sorting reproducibility between the nurses. Methods This is a prospective observational study conducting among the nursing staffs and nursing students, selected from Caen University College Hospital and Lisieux Hospital Center emergency departments between two months. Each group individually rank 60 referent clinical cases composed by scales designers. An assessment of scale practicality is collected after for each tool. The collected parameters are analyzed by a Cohen kappa concordance test (κ). Results With 8151 triage results of gold standard scenarios sorting in two scales by the same nurses, the FRENCH scale seems to give better triage results than the US ESI scale (nurse: FRENCH 60% and ESI 53%, p = 0.003 ; nursing students: FRENCH 49% and ESI 42%, p < 0.001). In the two groups ESI has also a big tendency to under-sort (p = 0.01), particularly for the most severe patients (p < 0.01). The interobserver sorting concordance for any experience gives good results for the FRENCH and the ESI without any difference (nurses : FRENCH KPQ=0.72 ESI KPQ=0.78; p = 0.32 ; students KPQ=0.44 KPQ=0.55; p = 0.22). Conclusion The ESI and FRENCH scales comparison on 8151 sorting results shows direct validity in favor of FRENCH one and similar interobserver agreement for both scales.

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.

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