Poor communication from hospital
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Reading the medical records on a client I was disappointed to read a hospital discharge letter to a GP that had no information on why the patient had been in hospital.
The woman in question was in advanced pregnancy and had suffered a very traumatic labour. Tragically her baby died. The letter from the hospital to the GP did not mention this, only the date she was discharged. The GP should have been informed of such a significant event. Without this vital information health care professionals in the community, such as the GP and community midwives, would be unable to to provide holistic care.
Hopefully such poor communication will not happen in the future as NHS England has issued a patient safety alert to help improve the quality and speed of communication with GPs and social care when patients are discharged from hospital.
The alert says communication at handover is identified as a particular area of risk and accounted for approximately 33% of the 10,000 incidents reported to the National Reporting and Learning Service (NRLS) between October 2012 and September 2013.
Review of these incidents identified that patients are sometimes discharged without adequate and timely communication of essential information at point of handover to all relevant staff and teams in primary and social care, including out-of-hours, and that information is not always acted on in a timely manner. "This can result in avoidable death and serious harm to patients due to a failure in continuity of care as well as avoidable readmission to secondary care," NHS England says.
NHS England is leading a national programme of work to support organisations in improving the communication and management of information at handover by building on successful local and national initiatives already in place.
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