{
  "abstract": "Introduction Completing discharge letters on time can be challenging, particularly on busy shifts. Successful completion involves various factors including ease of the process, availability of staff, and robust IT support. At our local hospital, we have had a long history of pending discharge letters which were resistant to previous attempts at improving the results. Previous audits had shown up to 600 incomplete letters per year due to various factors and the resultant effect on the quality of patient care, satisfaction of parents, complaints, and difficulty in retrospective completion. This quality improvement project was initiated to address this long-standing issue in our departmentMethod We incorporated new electronic patient records (EPR) where the discharge letters could be completed with ease and ensured all key stakeholders were aware of adding patients to the record on admission. We then created a discharge buster team comprising a consultant, resident doctors, a nursing member, and one of the managers. The nursing team was issued reminders that no patient should be discharged without letters and if the patient does go home without a letter for whatever reason then they would note this in the outstanding jobs list on EPR with details of why the letter couldn’t be completed. The discharge buster team then would review the outstanding list at 0930am every morning after handover. If any letters were identified, then the responsible resident doctor would be made aware and the letter completed within the next 4 hours. Any departure from this process would be investigated with necessary feedback to the staff involved.Results We used this process for a month and our usual outstanding number of discharge letters dropped from 50 to 11 and all the outstanding ones were completed on the day of the identification resulting in no outstanding discharge letters in that month. We have now made the consultant of the week with designated weekly resident doctors and nurse in charge to be the discharge buster team every week. Any outstanding letters would be the responsibility of the consultant of the week to ensure completionDiscussion This project has been successful in ensuring ease of process, involving all key stakeholders, and continued monitoring of results. Ensuring the patient goes home with an appropriate discharge letter is part of clinical care and this project has helped in improving the process. Continued monitoring would help understand if the changes made would have a long-standing impact.",
  "authors": [
    {
      "affiliations": [
        "Bedford Hospital NHS Trust"
      ],
      "name": "Pramod Nair"
    },
    {
      "affiliations": [
        "Bedford Hospital"
      ],
      "name": "Esi Kemevor"
    },
    {
      "affiliations": [
        "Bedford Hospital"
      ],
      "name": "Humayun Amjad"
    },
    {
      "affiliations": [
        "Bedford Hospital"
      ],
      "name": "Helen Lindsay Clarke"
    }
  ],
  "title": "8028 QIP: Resolving the pending discharge letters quagmire!",
  "uid": "c4c3d908-0917-52b1-a723-63993bcf1917"
}