Improving the percentage of electronic discharge summaries completed within 24 hours of discharge

摘要

EDSs are an important part of patient care and medical communication. The GWH has a financially motivated target stating that 95% of EDS are to be completed within 24 hours of patient discharge. On review of a six-week pre-intervention period, the medical ward mean weekly EDS completion rate within 24 hours was 74.3%.EDSs form a significant part of junior doctor workload. We found that on a medical ward the mean completion time for one EDS was 18.25 minutes. In January 2014, 387 EDSs were written between four medical wards. This equates to 29.25 hours per week of junior doctor time spent completing EDSs on the four main medical wards.Our aim was to improve the percentage of EDSs completed within 24 hours of discharge from medical wards in the GWH.We proposed and implemented two interventions:1) Five day EDS summary2) Protected EDS hour.The five day EDS summary was implemented on wards 1 and 2. The protected EDS hour on ward 3.Ward 1: mean pre-intervention EDS completion rate: 81.1% (six months pre-intervention). This increased by 7.9% to 89% (four week mean EDS completion rate post-intervention)Ward 2: mean pre-intervention EDS completion rate: 75.2%. This increased by 11.6% to 86.8%Ward 3: mean pre-intervention EDS completion rate: 71%. This increased by 4.5% to 75.5%Control ward: mean pre-intervention EDS completion rate: 85.1%. This increased by 5.1% to 90.2%Our results show the five day EDS summary led to a mean 9.75% improvement and the protected EDS hour a mean 4.5% improvement in EDS completion rates. A 5.1% increase was seen on the control ward suggesting confounding factors in this data which are most likely the trust EDS working group, junior doctor experience and EDS project publicity.