1. SMART COMMUNICATION: Improvement of discharge summary quality using Junior Medical officer targeted education strategies Gillian Sharratt, Kate Oliver

2. Background 2010 SAFER Medicines group undertook a priorities assessment of current issues in the hospital system Issue of changes to patients medications whilst in hospital selected for project work DUE methodology, project referred to NSW DUE support group. Literature search to identify the barriers to communication and documentation in discharge summaries

3. Objectives Describe the extent to which explanations for changes to patients medicines are being documented in discharge summary (QUM Indicator 5.3) To increase awareness of APAC guiding principles within the hospital setting – –Guiding Principle 9: Communicating Medicines Information To optimise the discharge summary as a communication tool to GPs in communicating explanations to patients medicine therapy.

4. Project timelines Development of project protocolJuly 2010 Submission to HRECAugust 2010 Expressions of interest for participation Local SSA approvalsOctober 2010 Last SSA received31 st Jan 2011 Last HREC approval received10 th March 2011

5. Multisite project DUE SG had oversight of project and the development of data collection tools Expert advisory group to develop intervention tools 16 hospitals recruited to participate (14 NSW, 2 ACT)

6. Methodology: Data collection QUM Indicator 5.3¹ Percentage of discharge summaries that include medication therapy changes and explanations for changes Retrospective review of patients discharged over a one week period (Jan 2010 and June 2011) ¹Indicators for Quality Use of Medicines in Australian Hospitals: NSW TAG 2007

7. Inclusion criteriaExclusion Criteria Neonates, children and adultsPatient stay 24 hours or less Patient stay greater than 24 hourspatient death during hospitalisation Patients discharge home alive, or to a residential aged care facility patients transferred to another hospital surgical patients ICD 10AM code: Z37 (maternity patients admitted for delivery only)

8. Definitions “Medication therapy changes” Changes to the patients pre-admission regimen which are intended to continue after discharge “Explanation for changes” Should include sufficient detail to inform future management decisions and should be explicitly documented in the discharge summary or letter

9. Data collection tool

15. Intervention development Barriers identified in literature search……………. Expert Advisory Group - CETI JMO rep - GP - Director Medical Services - Paediatric consultant form SCH - Quality manager - Senior Pharmacist Education and Training

16. Interventions

25. Discussion/conclusion

26. Recommendations