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Transcript of SMART COMMUNICATION: Improvement of discharge summary quality using Junior Medical officer targeted...
SMART COMMUNICATION:Improvement of discharge summary quality using Junior Medical officer
targeted education strategies
Gillian Sharratt, Kate Oliver
Background
• 2010 SAFER Medicines group undertook a priorities assessment of current issues in the hospital system
• Issue of changes to patients medications whilst in hospital selected for project work
• DUE methodology, project referred to NSW DUE support group.
• Literature search to identify the barriers to communication and documentation in discharge summaries
Objectives
• Describe the extent to which explanations for changes to patients medicines are being documented in discharge summary (QUM Indicator 5.3)
• To increase awareness of APAC guiding principles within the hospital setting – – Guiding Principle 9: Communicating Medicines Information
• To optimise the discharge summary as a communication tool to GPs in communicating explanations to patients medicine therapy.
Project timelines
Development of project protocol July 2010
Submission to HREC August 2010
Expressions of interest for participation
Local SSA approvals October 2010
Last SSA received 31st Jan 2011
Last HREC approval received 10th March 2011
Multisite project
• DUE SG had oversight of project and the development of data collection tools
• Expert advisory group to develop intervention tools
• 16 hospitals recruited to participate (14 NSW, 2 ACT)
Methodology: Data collection
• QUM Indicator 5.3¹ • Percentage of discharge summaries that include
medication therapy changes and explanations for changes
• Retrospective review of patients discharged over a one week period (Jan 2010 and June 2011)
¹Indicators for Quality Use of Medicines in Australian Hospitals: NSW TAG 2007
Inclusion criteria Exclusion Criteria
Neonates, children and adults Patient stay 24 hours or less
Patient stay greater than 24 hours patient death during hospitalisation
Patients discharge home alive, or to a residential aged care facility
patients transferred to another hospital
surgical patients
ICD 10AM code: Z37 (maternity patients admitted for delivery only)
Definitions
“Medication therapy changes”Changes to the patients pre-admission regimen which are intended to continue after discharge
“Explanation for changes”Should include sufficient detail to inform future management decisions and should be explicitly documented in the discharge summary or letter
Data collection tool
Intervention development• Barriers identified in
literature search…………….
Expert Advisory Group - CETI JMO rep
- GP
- Director Medical Services
- Paediatric consultant form SCH
- Quality manager
- Senior Pharmacist Education and Training
Interventions
Interventions
Interventions
Interventions
Discussion/conclusion
Recommendations