AB016. SOH24AB_190. Unveiling insights: an in-depth examination of discharge summaries in the Urology Department, Limerick Hospital Group—August 2023 closed loop audit

Background: The Health Information and Quality Authority (HIQA) has set a national standard for patient discharge summary information to ensure comprehensive and standardized communication between hospital and primary care settings. This study aimed to evaluate the compliance of discharge summaries with these guidelines through full close loop involve two audit cycles.

Methods: A retrospective review of 50 discharge summaries from the last months was conducted for each audit cycle using the E-discharge and patient flow system.

Results: In the first cycle, patient details, primary care details, admission/discharge details, and management plans were documented in 100% of summaries. Clinical narrative was included in 96%, diagnosis in 68%, and operations named in 22%. Allergies, alerts, and adverse events were not documented in any summary, medications on discharge were included in 24%, and patient advice was present in 8%. After implementing changes, including interdepartmental teaching and continues assessment and feedback, the second cycle revealed improved compliance. Management plans, clinical narrative, diagnosis, and operations were documented in 100%, 97%, 89%, and 75% of summaries, respectively. Adverse events were included in 20% of summaries. Medications on discharge improved to 98% and patient advice to 40%.

Conclusions: Despite focused interventions and improvements in the second cycle, adherence to HIQA standards remains suboptimal. Further education and system changes are warranted to improve compliance, particularly in documenting high-risk clinical information. This will enhance the quality and safety of discharge communication between this tertiary hospital and primary care.

Keywords: E-discharge summaries; Health Information and Quality Authority guidelines (HIQA guidelines); patient discharge; compliance; clinical audit