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