Processing discharge summaries in general practice: a qualitative interview study with GPs and practice managers

Spencer, Rachel A.; Rodgers, Sarah; Salema, Ndeshi; Campbell, Stephen M.; Avery, Anthony J.

Abstract

Background

Discharge summaries are essential for communicating patient information from secondary care to general practice on hospital discharge. Although there has been extensive research into their design and completion in secondary care very little is known about primary care processing of these documents.

Aim

To explore what general practice staff think are the factors associated with failure to respond to actions requested in discharge summaries and what practices do to mitigate this.

Design and Setting

Semi-structured interviews with primary care staff in three geographical regions of England.

Method

Interviews with ten practice managers and ten GPs at each of ten practices were undertaken to explore management of discharge summaries.

Results

Five themes emerged. The Secondary care factors theme describes participants’ perspectives on design of summaries, which are inconsistent and often require improvement. The Safety features of processing systems theme focuses on document handling in primary care. A theme devoted to Medicines reconciliation follows. Error and harm as a result of faulty processing is a theme describing ‘human error’ and other factors that participants believed contributed to failure to respond to requested actions. Finally, the strategies for safety improvement theme describes initiatives to prevent failures of safer transitions of care.

Conclusion

Correct processing of discharge summaries is essential to ensuring patients experience a safe transition of care and not just a hospital discharge. Based on our interview findings we suggest strategies to mitigate against faults in the processing of discharge summaries to enhance safer transitions of care.

Citation

Spencer, R. A., Rodgers, S., Salema, N., Campbell, S. M., & Avery, A. J. (2019). Processing discharge summaries in general practice: a qualitative interview study with GPs and practice managers. BJGP Open, 3(1), https://doi.org/10.3399/bjgpopen18X101625

• Journal Article Type: Article
• Acceptance Date: Aug 20, 2018
• Online Publication Date: Jan 23, 2019
• Publication Date: Apr 1, 2019
• Deposit Date: Sep 18, 2018
• Publicly Available Date: Jan 29, 2019
• Journal: BJGP Open
• Electronic ISSN: 2398-3795
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 1
• DOI: https://doi.org/10.3399/bjgpopen18X101625
• Keywords: Patient safety; General practice; Primary care; Care transition; Patient discharge
• Public URL: https://nottingham-repository.worktribe.com/output/1080546
• Publisher URL: https://bjgpopen.org/content/early/2019/01/23/bjgpopen18X101625
• Contract Date: Jan 29, 2019