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Objectives Prompt review of investigation results is essential for maintaining patient safety.1 Clinically stable patients are often discharged before receipt of pending results. Guidance state, an outstanding job proforma is to be completed post-discharge with timely follow-up. Standards require urine cultures and swabs to be chased within 48 hours, and blood cultures within 48–96 hours. Regrettably, timely follow-ups of these proformas are frequently breached, risking fatal near misses compromising patient care. We aimed to increase the percentage of timely chased results post-discharge from a baseline of 0% to 100% by October 2024. Methods A retrospective audit of 88 discharges over April 2023 was done. We measured the percentage of inpatient pathologies acknowledged before discharge and follow-ups that needed booking. We audited the percentage of proformas completed as per existing protocols and subsequent time required for proforma follow-up. A questionnaire was given to doctors to assess their current awareness and scope suggestions. The team included doctors of va rious grades, resulting in 14 completed questionnaires. The project was presented at the local clinical governance meeting for MDT feedback, highlighting barriers to an error-free and timely chasing of results. Results In April 2023, amongst 18 patients requiring follow ups, 44% (n=8) had no job proforma's completed. The remaining 56% (n=10) needed an average of 36 days to chase up results with 0% timely follow-ups. 9 patients required medical follow up after discharge, with only 5 having followed up in a timely manner. The survey revealed a baseline of 13% staff awareness. We noted several errors, from minor issues like proforma mislabelling to critical oversights such as not sending post-discharge samples. We used a multidisciplinary approach to address these spectrums of errors. Our first PDSA cycle introduced an outstanding job book, a restructured outstanding job proforma, and educating departmental staff. Out of 80 discharges, 84% (n=21) proforma completion was observed during a reaudit of 25 discharges requiring follow-up. Reaudit was conducted two weeks after implementing changes. The project achieved 64% of timely follow-ups and average follow-up time improved from 36 days to 3.6 days in the same period. We also significantly increased the acknowledgement of pathologies before discharge, improving from 66% to 95%. Table 1 summarises the results. Conclusion There was an overall improvement 2 weeks into the revised post-discharge protocols. Email/poster reminders and a follow-up staff survey in upcoming cycles are underway. We plan to conduct fortnightly audits to guide the ongoing PDSA cycle. References Good Medical Practice, General Medical Council 2013
Gnanendran et al. (Tue,) studied this question.