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Adult patient perspectives on receiving hospital discharge letters : a corpus analysis of patient interviews

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Weetman, Katharine, Dale, Jeremy, Scott, Emma and Schnurr, Stephanie (2020) Adult patient perspectives on receiving hospital discharge letters : a corpus analysis of patient interviews. BMC Health Services Research, 20 . 537. doi:10.1186/s12913-020-05250-1

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Official URL: https://doi.org/10.1186/s12913-020-05250-1

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Abstract

Background
UK government guidelines and initiatives emphasise equity in delivery of care, shared decision-making, and patient-centred care. This includes sharing information with patients as partners in health decisions and empowering them to manage their health effectively. In the UK, general practitioners (GPs) routinely receive hospital discharge letters; while patients receiving copies of such letters is seen as “good practice” and recommended, it is not standardised. The effects and consequences of whether or not this happens remains unclear. The aim of this study (one of three forming the Discharge Communication Study) was to explore patient perspectives on receiving discharge letters and their views on how this could be improved in order to optimise patient experience and outcomes.

Methods
Semi-structured interviews were conducted with a diverse sample of 50 patients recruited from 17 GP surgeries within the West Midlands, UK. All participants were adults with a recent episode of general hospital inpatient or outpatient care. Data were audio recorded, transcribed and analysed using mixed methods corpus linguistics techniques.

Results
Participants reported inconsistent access to discharge letters. Most wanted to receive a copy of their discharge letter although some expressed reservations. Perceived benefits included: increased understanding of their condition and treatment, reduced anxiety, and increased satisfaction. Consequences where participants had not received letters included: letter inaccuracies being overlooked, missed follow up actions, failure to fully remember diagnosis, treatment, or self-management or recommendations, and confusion and anxiety at what occurred and what will happen next. Participants felt the usefulness of receiving copies of letters could be increased by: including a patient information section, avoidance of acronyms, and jargon or technical terms explained with lay language.

Conclusions
Most patients value receiving copies of hospital discharge letters, and should be consistently offered them. Patients’ preferences for letter receipt could be logged in their health records. To enable positive outcomes letters should have a clear and accessible format that reflects the priorities and information needs of patients. Patients appear not to be receiving or being offered copies of letters consistently despite UK policies and guidelines supporting this practice; this suggests a need for greater standardisation of practice.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Centre for Applied Linguistics
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Communication in medicine, Hospitals -- Admission and discharge, Patient discharge instructions
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed central
ISSN: 1472-6963
Official Date: 15 June 2020
Dates:
DateEvent
15 June 2020Published
23 April 2020Accepted
Volume: 20
Article Number: 537
DOI: 10.1186/s12913-020-05250-1
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
ES/J500203/1[ESRC] Economic and Social Research Councilhttp://dx.doi.org/10.13039/501100000269
UNSPECIFIED Coventry and Warwickshire Clinical Commissioning Grouphttps://coventrywarwickshireccg.nhs.uk/
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