General practitioner–hospital communications: A review of discharge summaries

Abstract

The objective of this study was to examine the reliability, effectiveness, accuracy and timeliness of hospital to general practitioner (GP) information transfer by discharge summaries produced in a general public hospital in New South Wales, Australia. A retrospective audit of 569 patient discharge summaries and related medical records with a targeted GP interview was performed to determine receipt and clinical value of the recorded information. The main outcome measure was the number and quality of discharge summaries received by patient-nominated GPs. Summaries written for patients discharged from hospital were estimated to be received by the patient-nominated GP in 27.1% of cases. Discharge summaries audited were rated as being 63.6% accurate, with errors occurring in all facets of production. The current method of discharge summary production and distribution is unacceptable. The high number of errors (36.4%) and the low rate of receipt (27.1%), indicates that resources invested in the production of the discharge summary could be better utilized to improve information transfer.

Impact of Electronic Prescribing System on Prescribing Error Rate at Patients’ Transition of Care: An Interventional Study

“…The lowest frequency of PEs reported in the discharge prescriptions were 20%, 17% and 6.3%, 10,[23][24][25] which are lower than our study reported (33.3%). Our study results are different from Callen et al where they reported that electronic discharge summaries have no impact on reducing MEs, according to them handwritten and electronic summaries have a similar rate of PEs which are contrary to our study as we have reported a reduction in incidence of PEs by using the electronic system.…”

Hospital Readmissions: Physician Awareness and Communication Practices

“…However, several authors have found discharge summaries are often missing important information, including discharge diagnosis, pending tests, follow-up plans, and discharge medications. [13][14][15][16] In our study, physicians frequently communicated to clarify similar clinical data, further supporting prior evidence that the discharge summary is frequently inadequate. Our study has several important limitations.…”

In-hospital medication reviews reduce unidentified drug-related problems

“…Medication errors are, however, also frequent at the interface between levels of care [31][32][33]. In order to minimise this problem, we have also developed and evaluated separate methods for use at admission to [34] and discharge from [35][36][37] hospital.…”