Improving the quality of patient discharge from emergency settings

This article describes a nurse-led telephone service that was introduced to improve the quality of patient discharge from the emergency assessment area (EAA) of a large NHS acute teaching trust. The service originated from concerns regarding the increasing volume of telephone enquiries received from patients after discharge. In addition, an audit of patients' discharge plans revealed a minimalist/cursory approach to documentation. To improve discharge practice, a nurse-led telephone follow-up was introduced for all patients within 24 hours of discharge from the EAA. Evaluation over the first 12 months demonstrated improvement in the quality of discharge documentation and more explicit discharge plans. The service has successfully addressed issues regarding follow-up arrangements, documentation, new prescribed medications and GP letters. For its second year of operation, the service has been refocused using criteria linked to a new 'patient-focused' discharge checklist before discharge, to determine who is most likely to need telephone follow-up.