The Discharge Dilemma: A Quality Improvement Initiative Reducing Delays in Paediatric Discharge Communication

Timely completion and transmission of electronic discharge summaries (EDS) are essential for supporting continuity of care and effective communication between secondary and primary care services.National guidance recommends that discharge summaries are sent to primary care within 24 hours of discharge.Local review within our paediatric department identified poor compliance with this target and a substantial backlog of outstanding discharge letters.The aim was to increase the proportion of discharge letters sent within 24 hours of discharge to at least 80%, while reducing the backlog and maintaining fewer than 20 outstanding discharge letters.A quality improvement project was undertaken using Plan-Do-Study-Act (PDSA) methodology.Baseline data demonstrated that 46.6% of discharge letters were sent within 24 hours, with a mean time to transmission of approximately 30 days.In addition, 505 discharge letters were outstanding.Interventions included staff education and awareness campaigns, process mapping, multidisciplinary engagement, and strategies to improve accountability for outstanding discharge letters.During the project period, the proportion of discharge letters sent within 24 hours increased to 82.4% in July 2026, with compliance remaining between 76.7% and 82.4% over the final three months.A focused backlog reduction strategy initially reduced the number of outstanding discharge letters from 505 to 336.Following a revised strategy emphasising shared accountability across 49 clinicians, the historical backlog was eliminated by August 2026.This project demonstrated that a combination of education, process redesign, multidisciplinary collaboration, and shared accountability can improve the timeliness of paediatric discharge communication while eliminating a substantial historical backlog.Addressing individual and system-level barriers was important to the improvement process.Continued monitoring will be required to sustain these gains.The impact on patient safety and clinical outcomes was not directly measured and warrants further evaluation.