Transcript Slide 1

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
Expert Advisory Group
- CETI JMO rep
- GP
- Director Medical Services
- Paediatric consultant form SCH
- Quality manager
- Senior Pharmacist Education
and Training
• Barriers identified in
literature
search…………….
Interventions
Interventions
Interventions
Interventions
Discussion/conclusion
Recommendations