Delayed discharge summaries unacceptable, says AMA

31 Aug 2023

GPs should receive a formal written update on their patients inside a week of any initial specialist consultation and within 24 hours of hospital discharge, the AMA has declared.

While not enforceable, the timelines are laid down in a new position statement amid mounting complaints from primary care doctors about discharge summaries from some institutions, which the AMA argues can affect care.

“The key to continuity of care between GPs and hospitals is comprehensive, accurate and timely two-way communication regarding the admission process, the in-patient treatment and the patients’ on-going care needs once discharged from hospital,” says the AMA statement, released last week (link here).

“When a GP initiates a referral to hospital, they have a responsibility to provide a comprehensive referral containing up-to-date health status and diagnoses, current medication list, the relevant investigation results and other relevant information including the details of relevant other healthcare practitioners involved in care to enable appropriate hospital access, assessment and management.”

“Equally, when a patient has received hospital care, the GP needs timely and comprehensive communication about the care provided, including transfer of care arrangements in order to enable the GP to continue providing high-quality care for the patient.”

According to the position statement, formal communication with a patient’s GP should occur:

  • Within 24 hours of unplanned patient admission, hospital discharge, ED/short-stay attendance and on patient death or other sentinel event
  • Within seven days of initial specialist outpatient consultation, changes in health status or medication at a specialist outpatient service and discharge from a specialist outpatient clinic
  • At least every week while a patient is under the care of a hospital in the home service

In addition, handheld paper-based clinical summaries should be given to the patient, particularly if seeing the GP for immediate follow-up, per the guideline.

Figures released earlier this year by the NSW Bureau of Health Information suggested hospitals had some way to go in reaching these targets.

Based on a survey of 22,000 patients who attended emergency departments in the state in 2021-22, 74% of patients in urban areas of NSW received a discharge summary and only 43% in rural areas.

Statewide, the figure was 64% compared to 65% the year before, according to the bureau (link here).

Already a member?

Login to keep reading.

Email me a login link