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64 Improving completion rates of discharge summaries for patients that die during their admission to hospital
  1. Heather Y Holyoak,
  2. Ningyu Chai and
  3. Farid Bazari
  1. Kingston Hospital NHS Foundation Trust


Introduction All patients admitted to hospital should have a discharge summary completed, including those that die during their admission. This ensures good continuity of care between secondary and primary care and allows for Bereavement support to be offered. We looked at the current level of discharge summaries being completed for these patients, and the quality of information provided.

Methods We initially identified patients who died between November and December 2018. 114 patients died. Only 35 (31%) patients had a discharge summary completed. A survey of doctors highlighted confusion about what documentation was required, they felt that they are often too busy to do summaries and see deceased patients as a ‘lesser priority’.

A project was conducted to highlight the importance of these summaries and to improve the quantity and quality of them. This included presenting our initial data at Grand Round, the Junior Doctor Forum and piloting a ‘Bereavement Box’ on one of the elderly care wards. This was used in morning board rounds to highlight summaries that needed to be done, but also as an opportunity to debrief and learn from deaths.

Results Following these changes, we looked at the deaths in June 2019. 55 patients died. 33 (60%) patients had a discharge summary completed. 100% of patients who died on the ward with the ‘Bereavement Box’ had a discharge summary.

Conclusions With these interventions, there was a 100% increase in discharge summaries being completed. However, there are still further improvements to be made. We plan to roll out ‘Bereavement boxes’ to all wards, make an automatic notification sent to the GP upon a patient‘s death and introduce Medical Examiners within the Trust. We hope that these interventions will ensure that all patients will have discharge summaries completed and there will be improved continuity of end of life care.

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