What do readers need? Qualitative requirements of medical discharge summaries from the recipients' perspective

Discharge summaries (DSs) are the primary communication tools in clinical medicine. The transfer of information and plans is essential to ensure consistent patient safety and continuity of care. Therefore, DSs play a key role in population health. However, the overall quality of DSs is considered deficient, and there is a notable lack of scientific knowledge and research in this field, particularly regarding the needs of physicians as the primary recipients of DSs and key providers of ongoing patient care. The purpose of this study was to explore their requirements concerning the content, structure, and processing of DSs.

A total of 159 outpatient primary care physicians (general practitioners, GPs) and specialists who refer patients to hospitals for various conditions were contacted across Germany using mixed sampling methods combining convenience, quota, and theory-driven sampling. Of these, 106 (66.67%) participated in telephone interviews. The interviews included nine open-ended questions, analyzed using Mayring's qualitative content analysis, and a 43-item questionnaire, evaluated quantitatively with descriptive statistical methods to assess DS characteristics.

Quantitative analysis revealed that recipients rated the prompt arrival of DSs, a clear treatment and diagnostic plan, and a coherent rationale as the most important requirements. The least important elements were newsletter-style content, patient contact information, patient ethnicity, and hospital logos or awards. Both quantitative and qualitative analyses identified similar priorities and challenges in DS content and structure. Sending a diagnosis list was considered a top priority by all physicians. While GPs placed high importance on diagnoses, treatment plans, and medication changes, specialists prioritized a logical line of reasoning.

This recipient-focused study highlighted specific areas for improvement in the content, structure, and delivery of DSs. Tailoring DS formats to the distinct needs of GPs and specialists has the potential to enhance their overall quality and utility. Ultimately, optimizing DSs may strengthen population health outcomes by improving care transitions, reducing adverse events, and supporting effective outpatient management across the healthcare system.