1099 Audit of Immediate Discharge Letters in General Surgery in Royal Alexandra Hospital

Aim To determine what percentage of immediate discharge letters for general surgical patients meet pre-defined standards. Method All immediate discharge letters (IDLs) for patients discharged over a week-long period from two general surgical wards in a single hospital were analysed. Results were compared to the 16 criteria outlined in current Scottish Intercollegiate Guidelines Network (SIGN) guidelines, plus 3 further criteria agreed locally. A template for IDLs was then created and distributed amongst junior doctors writing IDLs after presentation at a local research meeting. Data was subsequently recollected recording the same criteria. Categorical data was analysed using a chi squared test. Results n=129 patients were included (n=67 in round 1; n=62 in round 2). Those without an IDL were excluded. On re-auditing, 15/16 (94%) of the SIGN criteria were documented more frequently, however only 5 of these were statistically significant (31.3%, p < 0.05). Results had also improved in all three of the locally agreed criteria, however only 1 of these was statistically significant. Overall, 0% of IDLs prior to the implementation of the template had all SIGN criteria present, rising to 6% after implementation of the template, however this was not statistically significant. Conclusions Implementation of an IDL template has improved the quality of IDLs for general surgery patients in the RAH, however further work is required to improve this further and create substantive change in the long-term.