Queen Elizabeth Hospital
I’m writing to you under the freedom of information act to request information relating to electronic discharge summaries within your trust.
1. I would like you to provide me with a monthly breakdown for patients who were discharged with a completed electronic discharge summary for the last 24 months
Please see attached: FOI 0285
2. How does the trust monitor / ensure oversight relating to discharge summaries for patients?
The Trust complies with the 24 hour turnaround time for discharge letters. The Trust generates a discharge letter out of its EPR – PICS (Prescribing Information Communication System).
The discharge letter is commenced upon admission and is added to iteratively across the episode of care. A patient cannot be discharged from the hospital without a discharge letter being completed.
There is an interlock with the discharge letter and the request for TTO’s – to take home drugs – if the discharge letter has not been completed the TTO’s cannot be ordered. As soon as the mandatory fields are completed and the patient is discharged the discharge letter is generated and sent immediately to the GP via Electronic Document Transfer directly into the GP system – where the practices utilise this facility.
The letter is also uploaded into our GP Practice Page which provides a practice centric view of the patient’s letters. If the GP is unable to receive the document via EDT the user is prompted to print and post a hard copy letter.
3. Where a patient is discharged from your patient administration system but the electronic discharge summary how is this flagged to the clinical team?
The discharge letter is commenced upon admission and is added to iteratively across the episode of care. A patient cannot be discharged from the hospital without a discharge letter being completed.
There is an interlock with the discharge letter and the request for TTO’s – to take home drugs – if the discharge letter has not been completed the TTO’s cannot be ordered.
4. If you have a system of ‘parking patients’ after discharge please provide an overview of this including any associated documentation including a screen shot of an example involving a ‘test patient’
The Trust does not ‘park patients’.
5. Please provide me with the current number of open electronic discharge summaries for your trust (i.e. those which have been started but not sent to GP for whatever reason)
The discharge process and letter generation is mandatory on discharge – see above. The system demands the letter is completed as part of the discharge process. Therefore we have no open letters for patients who have been discharged that have not been sent to the GP.
The system mandates completion and distribution.
6. Please provide me with a copy of the trust approved clinical policy or standard operating policy relating to electronic discharge summaries.
The approved process for discharging a patient is covered within the Trust’s training manual for the PICS – please see attached: DischargeSummaryTrainingDocument
Heartlands, Good Hope and Solihull Hospital
I’m writing to you under the freedom of information act to request information relating to electronic discharge summaries within your trust.
1. I would like you to provide me with a monthly breakdown for patients who were discharged with a completed electronic discharge summary for the last 24 months
We do not hold this information.
Discharge summaries are produced from two main sources. Patients that are inpatients and who are registered on Electronic Prescribing have the discharge summary produced electronically as part of the mandatory discharge process and it is tied in with the discharge TTO prescriptions.
Some discharge summaries, for example with day patients where electronic prescribing may not be used, are done as clinical letters where the summary is dictated by the clinician and then sent to the secretaries for production.
2. How does the trust monitor / ensure oversight relating to discharge summaries for patients?
When a discharge summary is produced on the electronic prescribing system, the consultant in charge is sent a notification where they can review and modify the discharge summary. After 72 hours the discharge summary cannot be modified.
The discharge summary is viewable in the electronic patient record through iCare, which is also accessible to GP’s, and our Concerto electronic patient record.
Once the discharge pack is completed in pharmacy a notification is also sent to the Johah board system (handover system) that provides information to the nursing staff on the status of patients so that they can plan the patient discharge.
3. Where a patient is discharged from your patient administration system but the electronic discharge summary how is this flagged to the clinical team?
The status of the patient is viewable on the first patient summary page – as to whether they are an inpatient and which ward they are on. On the front section of the patient record in Concerto (patient system) is a section for admissions, transfers and discharges (ADT’s) which gives details of all the admissions, and discharges and discharges for the patient. Under the section for eTTO are all the electronic discharge summaries.
With patients that have not been admitted onto electronic prescribing, the discharge summary can be viewed under the clinical letters section.
4. If you have a system of ‘parking patients’ after discharge please provide an overview of this including any associated documentation including a screen shot of an example involving a ‘test patient’
The Trust does not ‘park patients’.
5. Please provide me with the current number of open electronic discharge summaries for your trust (i.e. those which have been started but not sent to GP for whatever reason)
We do not hold this information.
6. Please provide me with a copy of the trust approved clinical policy or standard operating policy relating to electronic discharge summaries.
The approved process for discharging a patient is covered within the Trust’s Discharge Procedure. Please see attached: Discharge Procedure – HGS
