Notes from the Safe Discharge Programme Board, held on Tuesday 08 February 2011, 1pm, Room A, CMO, SDGH

Present: James Leighton (Chair) (JL); Dr Henry Gibson (HG); Laura Gwynne (LG);
John Williams(JW); Dr Bapi Biswas (BB); Victoria Raby (VR); Cathy Butcher (CB)
and Dr Graham Butcher (GB)
Apologies: Dr Geraldine Boocock; Dr Niall Leonard; Dr Tim McBride; Tracy Rawlings,
Kate Monaghan and Emily Hoban
Notes: Marie Hatton
2.
Welcome and Introductions / After welcome and introductions, James highlighted 2 workstreams:
  • The Trust’s abillity to discharge summaries to GPs, within 24 hours
  • The Trust’s ability to discharge letters within 2 weeks to the GPs.
There is a software tool called e-prescribe, which can electronically provide a discharge summary and JW confirmed a live pilot has already taken place on 3 Wards and will be rolled out to all Wards in due course
JL also confirmed that this Safe Discharge Programme Group will make its recommendations to Trust Board on the sustainability of discharge summaries and letters.
3.
Discharge Summaries / 3.1Progress Report – JL and JW are confident this Programme is on track to deliver:
  • Discharge Lounge (now in operation)
  • F1s now trained
  • F2s to be trained this week.
3.2Issues (Computer Hardware) – There has been a delay in ordering the hardware, but this order has now been placed.
HG raised his concerns that the IT has to work with sufficient hardware and that all users are confident with this.
BB raised the query over RAG (Red, Amber, Green) drugs and acute drugs being detailed on the Discharge Summaries and JW confirmed there are three sections for this detail, namely:
  • not for discharge,
  • items for discharge not to be continued
  • not for discharge which can be manipulated.
The duration for these drugs can be added electronically.
The Programme is keen for more techniciansupport on short stay wards now as the high turnover of patients is a concern.
3.3Development of a single discharge communication – BB is happy with the e-discharge summary as long as all the information is added with a Free Text section included.
JL tabled Dr Niall Leonard’s concerns for Sefton patients and says the e-discharge will work for Planned Care but Sefton GPs want a letter for Unplanned Care.
4.
Discharge Letters / 4.1Progress Report – JL and CB have been gathering qualitative issues from the Medical Secretaries and three Audits have now been completed with a Trust target of 50% compliance of discharge letters to be with GPs within 2 weeks. The recent Jan-Mar 2011 Audit showed the following:
Jan
Surgery / 64%
Medicine / 16%
Two issues have become apparent from these audits and HG asked if the ratio of Doctors to Patients had been taken into consideration:
  • Discharge letters being typed a considerablelength of time after discharge
  • Batching of dictation and signing off of letters.
Action: JL to circulate audit results by consultant.
4.2Issues Report
4.2.1Medicine Performance – see above
4.2.2EAU use of symphony and paper proforma – There is a noticeable bottleneck in this area, due to the high turnover of patients within EAU and the lack of time for discharge summaries to be completed. HG confirmed that plan in for these to be electronically completed, rather than handwritten.
There was robust discussion around the possibility of sending the PTWR (Post Take Ward Round) Form for EAU patients only, direct to the GPs, rather than duplicating this evidence on the Discharge Summary, with the drug detail inputted onto the Free Text Section.
Action: JL and JW to review TTO on Symphony with Jackie Greenwood to see if this could be utilised in some way.
Action: JL to organise current and future state mapping as a way of reducing bottlenecks in this area.
4.2.3Medical Records & Coding Performance – not discussed / JL
JL/JW
5.
AOB / None reported.
6.
Next Meeting / Wednesday 16 March, 2pm, Boardroom, CMO, SDGH
Apologies please to
JL encouraged everyone to obtain a password to the NHS Networks site, where all Agendas, Minutes and Dates of Meetings will be stored, along with any other background papers and you should all have an invitation to now log on to:

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