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Setting standards to improve women’s health. Royal College of Obstetricians and Gynaecologists. Risk Management and Medico-Legal Issues In Women’s Health Joint RCOG/ENTER Meeting. Please turn off all mobile phones and pagers.
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Setting standards to improve women’s health Royal College ofObstetricians andGynaecologists Risk Management and Medico-Legal Issues In Women’s Health Joint RCOG/ENTER Meeting Please turn off all mobile phones and pagers
Good Communication is the Key to Delivering High Quality Clinical Care and Reducing Complaints Dr M Adishesh, ST1 Trainee Mr. EC Nwosu, Consultant Obstetrician and Gynaecologist, Whiston Hospital
Introduction ‘Sharing information with other healthcare professionals is important for safe and effective patient care’ GMC, Good medical Practice(2006) ‘ The immediate discharge document is an important instrument for effective communication between secondary and primary care ’ SIGN guideline no 65 The Immediate Discharge Document(2003)
Background • Recently received complaints from GP’s regarding emergency summaries / not received / not legible/ contain inadequate information • Formal discharge letters - take time to reach GP’s • Formal dictation • Typing • Signature • Postage • To reduce delay, hand written discharge summaries are completed (in triplicate) by doctors • First copy - given to patient to give to GP • Middle copy - faxed to GP • Third copy - filed in patient notes
Aims and Objectives • To assess the quality of emergency discharge summaries to general practitioners • Determine reasons for complaints • Make recommendations required to improve communications
Materials and Methods • Prospective study • Obstetrics & Gynae Unit – Whiston Hospital Affiliated to Univ of Liverpool • Information was gathered from 100 emergency discharge summaries completed by junior doctors in the unit • Over three months period ( Dec 07-Feb 08) • 10 summaries were used as controls and faxed (5 top & 5 middle copies) to an in-house number to check the quality of faxed materials received by GP’s
Information abstracted • Full patient details • Consultant • Date of admission and discharge • Diagnosis • Procedure / complications • Treatment • Follow up arrangement • Signature / legibility / status
Conclusions • Discharge summaries completed appropriately, there is room for improvement • 84 % of cases had correct GP details • Some GP’s didn’t receive the communication • Patients failed to hand in discharge summary to GP • Incorrect GP fax number • Surgery had moved • Only 50% of faxed summaries (control) were legible • All top copies were legible • Middle copies - usually faxed to GP’s were not very legible (main cause of complaints)
Recommendations • Ensure all aspects of discharge are completed adequately • Top copy of triplicate form be faxed to GP’s • ? Followed by a phone call / diffic weekends / • One copy discharge summary (only), filed in patients notes after being faxed to GP for: - consistency /environ friendly / reduce complaints • Use electronic discharge summary system that can be electronically sent to improve consistency, compliance and legibility (issue already being addressed by Trust) • Communicate with GP’s to update unit regularly with their surgery details on relocation and telephone & Fax details • Re- audit in 12 months
Thank You For Listening Any Questions ?
Setting standards to improve women’s health Royal College ofObstetricians andGynaecologists Risk Management and Medico-Legal Issues In Women’s Health Joint RCOG/ENTER Meeting Please turn off all mobile phones and pagers