How can communication to GPs at hospital discharge be improved? A systems approach.
communication
interprofessional communication
patient discharge
patient safety
primary–secondary care interface
service improvement
systems approach
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
07
08
2021
accepted:
12
08
2021
pubmed:
9
10
2021
medline:
9
10
2021
entrez:
8
10
2021
Statut:
epublish
Résumé
Poor communication to GPs at hospital discharge threatens patient safety and continuity of care, with reliance on discharge summaries that are commonly written by the most junior doctors. Previous quality improvement efforts have largely focused on adherence to standardised templates, with limited success. A lack of understanding has been identified as a cause of the issue's resistance to decades of improvement work. To understand the system of communication to GPs at hospital discharge, with a view to identifying potential routes to improvement. A qualitative exploration of the secondary-to-primary care communication system surrounding a large UK hospital. A systems approach, recently defined for the healthcare domain, was used to structure and thematically analyse interviews ( The largely one-way communication system structure and the low level of hospital stakeholder insight into recipient GP needs emerged as consistent hindrances to system performance. More open lines of communication and shared records might enable greater collaboration to share feedback and resolve informational deficits. Teaching sessions and assessments for medical students and junior doctors led by GPs could help to instil the importance of detail and nuance when using standardised communication templates. Facilitating the sharing of performance insights between stakeholder groups emerged as the key theme of how communication might be improved. The empirical measures proposed have the potential to mitigate the safety risks of key barriers to performance such as patient complexity.
Sections du résumé
BACKGROUND
BACKGROUND
Poor communication to GPs at hospital discharge threatens patient safety and continuity of care, with reliance on discharge summaries that are commonly written by the most junior doctors. Previous quality improvement efforts have largely focused on adherence to standardised templates, with limited success. A lack of understanding has been identified as a cause of the issue's resistance to decades of improvement work.
AIM
OBJECTIVE
To understand the system of communication to GPs at hospital discharge, with a view to identifying potential routes to improvement.
DESIGN & SETTING
METHODS
A qualitative exploration of the secondary-to-primary care communication system surrounding a large UK hospital.
METHOD
METHODS
A systems approach, recently defined for the healthcare domain, was used to structure and thematically analyse interviews (
RESULTS
RESULTS
The largely one-way communication system structure and the low level of hospital stakeholder insight into recipient GP needs emerged as consistent hindrances to system performance. More open lines of communication and shared records might enable greater collaboration to share feedback and resolve informational deficits. Teaching sessions and assessments for medical students and junior doctors led by GPs could help to instil the importance of detail and nuance when using standardised communication templates.
CONCLUSION
CONCLUSIONS
Facilitating the sharing of performance insights between stakeholder groups emerged as the key theme of how communication might be improved. The empirical measures proposed have the potential to mitigate the safety risks of key barriers to performance such as patient complexity.
Identifiants
pubmed: 34620598
pii: BJGPO.2021.0148
doi: 10.3399/BJGPO.2021.0148
pmc: PMC8958742
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2021, The Authors.
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