Showing Love to Letters: Improving the Completeness and Clarity of Care Plan in Patient Discharge Letters

Methods:

The project was conducted over a three-month period. Firstly, baseline diagnostics of the cause and extent of the problem was completed through observation, discussion with patients and colleagues, as well as use of tools like process map, fishbone diagram, and bar chart. The Model for Improvement informed design of the project based on these diagnostics. An aim was set, and a robust definition of measures was created with inclusion and exclusioncriteria. I completed a baseline run chart, sampling 20 discharge summaries. This gave me a median baseline to establish any statistically significant changes following implemented changes and subsequent sampling of all (20) further discharge summaries completed throughout the project. Using the Plan–Do–Study–Act (PDSA) methodology, I captured change ideas with my team and multi-faceted interventions were implemented. The discharge template was adjusted to include prompts for all relevant categories of the discharge summary. Additional interventions included early allocation of doctors to discharge summaries and education (via email, team doctors’ meeting, induction document about writing discharge letters, one-to-one teaching and feedback) for doctors writing discharge summaries.