A year post-deployment, Hull and East Yorkshire Hospitals NHS Trust and The Ridings Medical Group reflect on the benefits realised from moving from paper to electronic Immediate Discharge Summaries.
To support improved communication, clinical workflow and more effective transfers of care, NHS England directed that from October 2015 secure fax would no longer be permitted for sending discharge summaries to GPs from NHS Trusts. Organisations were encouraged to adopt either secure email or direct electronic transmission to send and receive all discharge summaries.
With over 160,000 inpatients being discharged to over 130 GP practices every year, Hull and East Yorkshire Hospitals NHS Trust took the opportunity to review the complete Immediate Discharge Summary (IDS) process, including postal deliveries.
The paper based approach to communicating discharge information challenged timely access to up-to-date patient information, both within and external to the Trust. This had a negative impact on:
- staff experience and efficiency
- patient experience and safety
- trust finances, with fines associated with the 24 hour target of GPs receiving the IDS not being met
Using eDischarge Summaries has led to a number of efficiency improvements, including:
- the electronic transmission of 'one version of the truth' in-patient discharge summaries
- hospital nursing and ward clerk staff can spend more time on direct patient care and administrative activities, approximately 23,000 hours per year re-invested (a £235,000 non-cash releasing saving)
- eliminating the need to fax, has made sending the IDS quicker by removing the need to confirm receipt with the receiver - previously, staff could try up to 5 times to send a fax, and some GP fax machines weren't even switched on at weekends
- removing the need for doctors to physically sign the IDS reduces further delays in sending the IDS, also supporting timely filing of the IDS in the patient record.
There have also been improvements to safety, including:
- increased legibility has been a factor in improving quality, richness and timeliness of documentation supporting
- patient care, assisted through the use of prompts in Lorenzo and access to the 'live' or finalised document dependent on department/care setting
The impact of eDischarge Summaries at a GP surgery
Before eDischarge Summaries, we expeienced:
- a reliance on phone lines being active to receive a IDS by fax
- illegible and minimal information, making it difficult to interpret and action
- multiple versions of a discharge summary received, with follow-up calls needed
- a labour-intensive method of grouping discharge summary papers together
- missing patient information in the discharge summary
Since using eDischarge Summaries, improvements have included:
- standard format, legible information that's easier to attach to patient records, with a simplified process
- faster actioning of discharge information, providing the ability to quickly follow up with patients, as required
- a full audit trail of information received and staff actions linked to the discharge summary