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G506(P) Quality improvement project to enhance the standard of paediatric transfer documentation
  1. LJL Halpin1,
  2. K Noordally2,
  3. N Pandya2
  1. 1Oliver Fisher Neonatal Unit, Medway Maritime Hospital, Gillingham, UK
  2. 2General Paediatric Department, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK

Abstract

Aims When children are transferred to other units, such as High Dependency (HDU) or Paediatric Intensive Care (PICU), it is common practice to provide a transfer letter. This is beneficial to the transport team and receiving unit, as well as the referring team. Often transfer letters, which may be handwritten (and difficult to decipher) are produced by juniors within the team and may be deficient in information. This can have an impact on patient safety, potentially affecting on-going care. As many NHS trusts move towards a paperless system, the use of computerised templates is becoming increasingly prevalent.

The aim of this project was to assess the quality of documentation for patients being transferred to an external HDU or PICU, pre- and post- implementation of a computerised pre-populated proforma. This proforma was devised to encourage the inclusion of relevant information, whilst improving efficiency by acting as both a transfer letter and a discharge summary for the GP.

Methodology A retrospective departmental audit analysing transfer letters for 31 patients during 2014, highlighted poor record-keeping in several areas, as shown in Figures A and B. Following this, a pre-populated template was created, with criteria thought to be useful for hospital records, the transfer team and receiving unit. This proforma was stored on our Trust electronic patient record system (Patient Centre©).

Results Documentation for 20 patients, transferred over a 7-month period during 2015, was retrospectively analysed, post-implementation of this proforma. Within our cohort, 9 patients did not have a letter; 6 had typed letters, and 5 had completed proformas. Data from the 2014 audit was subsequently compared to those cases where a proforma was completed. Figures A and B show this comparison.

Conclusion As demonstrated in Figure A, there was enhanced recording of demographic information, notably next-of-kin and GP, with this proforma. Figure B also shows improvement in the reporting of several criteria, especially examination findings, observations and ventilatory support. Despite our current sample size, we feel that the quality of transfer documentation will continue to improve with on-going use of our proforma.

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