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95 Implementing electronic discharges at a non-NHS hospice: the benefits and many challenges
  1. Siwan Seaman
  1. Marie Curie Hospice Cardiff and the Vale


Aims The aim of the eDischarge project was to share discharge advice letters (DALs) with all relevant healthcare professionals at the point of discharge. The existing process was for letters to be dictated, typed, corrected by a clinician, amended by admin and sent in the post.

Methods This quality improvement project used improving quality together (IQT) methodology. The measure chosen to monitor progress in reaching the aim was the time between discharge from the hospice and the DAL being sent to the GP. The ward secretary held a database of all discharge dates and completion dates of DALs which allowed us to measure the times taken as a weekly average to plot on a run chart. A pilot of MTeD (the electronic discharge prescription and DAL programme used within the Welsh NHS Clinical Portal in use across all Health Boards in Wales) occurred during 2 weeks in June 2018.

Results Prior to the pilot the mean time from discharge to letter being posted over a 10 week baseline period of data collection was 6.9 days. During the 2 week pilot this average dropped to 1.5 days. In addition, following the point of release the electronic version was reaching GPs within 4 hours of discharge as opposed to being dependent on variable postal times.

Discussion and conclusion The results of the pilot are indisputable with significant reductions in the delay in sharing medication and clinical information with key professionals and provide the added benefit of being available on the NHS clinical portal for other healthcare professionals to access e.g. if the patient attends A and E the day after discharge. However, many challenges relating to use of the relevant NHS clinical applications and IT infrastructure in a third sector setting needed to be overcome.

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