Background Accurate and timely communication between primary and secondary care is essential for delivering high-quality patient care (Dinsdale, Hannigan, O’Connor e al. Fam Pract. 2020; 37(1):63–68). Communication and collaboration between primary care and palliative care providers is needed to deliver complex care management and to coordinate care, and letters form an important modality for this (Professional Record Standards Body. Outpatient letter v2.1. [internet]). There is increasing evidence that GPs prefer to receive structured clinic letters from specialists, with clearly communicated problem lists and outcomes.
Aims To assess the effectiveness of GP update letters in communicating key messages and outcomes of a patient encounter with the specialist community palliative care team.
Methods To evaluate our template based GP update letters over a period of two months, assessing accuracy, timeliness, and clear conveyance of key messages including recording:
Specific problem(s) for which the specialist team are offering advice.
Investigations and change of management plan.
Rationale for medication changes and prescription requests.
Controlled medication requests given specific doses.
Actions requested of General Practitioners in clear courteous manner, including urgency of action.
Results Interim data at two weeks: 37 letters sent. 86% sent same day. 100% recorded primary diagnoses. 37% recorded secondary diagnoses. 89% clearly outline relevant problems. 87% made a clear prescription request. 19% of letters requesting controlled medications did not specify doses.
Conclusion Interim analysis shows GP update letters were sent within 48 hours. Areas of improvement could include recording secondary diagnoses, further clarity around specific problems such as problem listing, and prescription requests, which for controlled drugs suggest doses. This ongoing audit is concurrent with further enquiry of the GP view via survey, and assessing an opportunity for letter writing training for the wider multi-disciplinary team, also by survey of confidence. Adding to the template format may assist these improvements.
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