6419 Quality and content of discharge summaries on the paediatric ward- audit

Objectives Discharge summaries are important handover documents to the GP and summary of patients' hospital stay. Variations were noted in quality of discharge summaries completed on the Paediatric wards, which were not compliant with the Professional Records Standard Body's e-Discharge summary guidance endorsed by the RCPCH (figure 1).1 We aimed to improve the quality and content of discharge summaries completed on the Paediatric ward to 40% within first 3 weeks. Our objectives were to determine the compliance of patient discharge summaries to standard practice, significantly reduce the use of medical jargon in writing discharge summaries, increase documentation of safety net advice to patients, and improve the general quality of patient discharge summaries. Methods A retrospective analysis of data collected from 70 randomly selected discharge summaries over 3 weeks (13/02/2023 to 05/03/2023) using plan-do-study-act (PDSA) cycle, with 35 discharge summaries in each 10 days cycle assessed against 9 key criteria using anonymized spreadsheet, to check percentage compliance to outlined standard. Inclusion criteria were patients whose discharge summaries were listed in the doctors' jobs list to be completed each day. Project was publicized on the wards and among colleagues for education and sensitization before 2nd PDSA cycle. 3rd PDSA cycle was repeated with further 35 discharge summaries (19–28/07/2023) and results compared. Results First PDSA cycle showed initial quality of discharge summaries at 14.2%, with 88.5% safety net advice and 60% medical jargons. By second cycle after 3 weeks, total compliance was 42.8% which exceeded the set aim of 40%, and use of medical jargons reduced to 23%. Total quality of discharge summaries at the end of the audit cycle was very significantly 71.4%, 8% medical jargon use, and advice to patients was consistently well documented. Conclusion This audit showed a significant overall improvement in quality of discharge letters. This is important as discharge summaries are important handover tools to the GP, summary of patient's hospital stay, and legal documents. There is therefore need for periodic learning on proper documentation of discharge summaries to ensure they are up to standard. Documenting safety net advice to patients is good practice, and it helps to improve patient safety and care. Following local presentation of this audit, the department adopted to incorporate teaching of proper documentation of discharge summaries into the orientation for new doctors, adopting this audit result as baseline reference. Reference Google Scholar. https://theprsb.org/wp-content/uploads/2019/02/eDischarge-Summary-Maintenance-Release-Implementation-Guidance-Report-v2.1-23.1.19.pdf.