A quality assurance activity to improve discharge communication with general practice

The aim of this study was to describe and evaluate a method of improving the completion of discharge summary information. As a quality assurance activity, a self-carbonating form for both the patient record and discharge letter was introduced to a general practice casualty (GPC) in Sydney, Australia, involving approximately 40 community GPs. Evaluation involved assessment of the change associated with this intervention on a cohort of GPs using logistic regression analysis, clustering at the level of the treating GP. The main outcome measure was completion of a discharge letter to the patient's usual GP. Provision of discharge letters increased from 30% prior to the intervention to 90% following it (P< 0.0005; OR 11.9; 95% CI 8.6-16.4). It was concluded that solutions to problems of quality are best developed at the system level. The use of a self-carbonating form to simultaneously generate a discharge letter and the medical record might be used by other similar services with good effect.