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One template does not fit all: where next to improve hospital discharge communication to primary care?
Nicholas Boddy1,2, Joanne Reeve3, Rachel A Spencer4
1Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
Abstract:
Led by national policy, standardisation has enhanced hospital discharge communication to primary care over recent decades. However, discharge summary content standards and their corresponding templates can be over-relied on by authors, risking the exclusion of important contextual and explanatory information for patients with more complex care.This information can be critical for GPs to deliver high quality, safe, and efficient post-discharge care, especially for this patient cohort which can be at higher risk of avoidable harm from suboptimal communication. Discharge summary authors can lack sufficient understanding of the recipient primary care perspective to mitigate this issue and communicate effectively through standardised letter templates. Strengthening this interprofessional understanding is an essential next step to improve discharge communication.In response to this challenge, we propose the basis of a new framework of interprofessional discharge communication that accounts for the different paradigms of specialism and generalism and supports summary authors to tailor their content to the patient's post-discharge care.We call for the co-development of this framework through a programme of applied research, alongside the exploration of primary-secondary care interface learning communities as a vehicle for interprofessional education. These initiatives can serve to augment the current strengths of standardised discharge summaries and mitigate their limitations, maximising the quality, safety, and efficiency of post-discharge care. Progress in this field can benefit wider cross-interface communications and practice and assist the NHS integration agenda.
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