| TITLE |
| Crouching Tiger, Hidden ICU Discharge Summary |
| BACKGROUND |
| The Intensive Care Society and Faculty of Intensive Care Medicine both have clear national guidelines regarding written handover for patients being discharged from ICU to ensure continuity of care and patient safety. At……, ICU discharge summaries have historically been completed on a system called CiTO, predominantly used for outpatient communication and letters. We surveyed clinical staff and demonstrated poor understanding of both the location of the letters and quality of information in the proforma. Subsequently, change was implemented to move the discharge letter to the electronic patient record (PPM), which is used throughout the hospital for contemporaneous inpatient documentation, resulting in improved handover of clinical information and patient safety. |
| METHODS |
| A survey was undertaken to assess the current awareness of how to access information regarding an ICU step down patient and where the information was located. We also asked where staff felt the discharge summaries should be located. The decision was made to improve the relevance of the information included in the discharge summary using survey feedback from current intensive care doctors. Following the redesign and implementation of the new ICU discharge summary template, we re-surveyed the awareness of the wider hospital teams on how to access information and where it was located. |
| RESULTS |
| Of the 71 respondents to the first survey, 42% were foundation trainees, 18% core trainees, 34% specialty trainees and 1.5% locum doctors, consultants and medical associate professionals (MAPs) respectively. Only 32% knew where an ICU discharge summary was located and 65% had struggled to find information regarding an ICU step down. This includes the 22 (31%) who had had jobs in ICU. When ICU trainees were surveyed regarding the discharge summary proforma in use, only 11% of the 18 respondents thought the original proforma was fit for purpose and 100% supported the relocation to PPM. Issues were identified including repetitive boxes and a limited word count which were corrected accordingly. Following the implementation of a new discharge summary and location, we re-surveyed staff at MYTT. Of the 20 respondents, 50% were foundation trainees, 25% core trainees, 15% speciality trainees and 10% MAPs. 85% now knew where to find the discharge summary and only 15% had struggled to find information. |
| DISCUSSION |
| Being unable to access information regarding an ICU stepdown patient raises significant patient safety concerns and may lead to undue stress on staff caring for patients. Through the actions of this quality improvement project there has been significant improvement in staff awareness of how to access ICU discharge summaries and where they are located. |
| ACKNOWLEDGEMENTS |
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| REFERENCES |
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