EP 183 Quality Improvement in Surgical Discharge Summaries: An Audit of the Performance of a London Tertiary Colorectal Surgery Department

Abstract

Discharge summaries are critical to continuity of care. The Professional Records Standard Body and Royal College of Physicians have published national guidelines on hospital discharge summaries. The aim of this audit was to assess the adherence of discharge summaries from a London tertiary centre colorectal surgery department to national guidelines and implement changes to improve discharge summary quality.

A scoring system based on national standards was created to assess 100 consecutive discharge summaries from March 2024 to April 2024 in the first cycle. These results were presented locally, with dissemination of a discharge summary proforma based on national standards. The second cycle involved assessing 100 consecutive discharge summaries from December 2024 to January 2025 using the same criteria to assess improvement.

The median and modal scores based on the criteria in the first cycle were 5.00/7.00. The mean score was 4.15/7.00. 4 patients did not have discharge summaries recorded on the system. The events/procedures during admission was the criterion with the highest adherence (89%), while safety netting advice had the lowest (14%). In the second cycle, the median and modal scores were 6.00/7.00, the mean was 6.06/7.00. Both median and mean score showed a statistically significant improvement. Reason for admission, events/procedures during admission and post-op plan had the highest adherence (100%), while safety netting advice had the lowest adherence (32%). All individual criteria showed a statistically significant increase in adherence.

The audit demonstrated successful quality improvement in surgical discharge summaries through the successful implementation of a proforma.