Hospital discharge summary timing and delivery to the GP

The hospital's medical records policy sets the completion window for the discharge summary, and the Communicating for Safety Standard in the National Safety and Quality Health Service Standards covers the clinical handover that discharge to a general practice is. In aurii the discharge note and the GP discharge summary are drafted together from the admission record on the discharge round, the specialist signs them, and the summary leaves for the nominated GP over Medical Objects on sign-off with the acknowledgement written back against it.

The discharge order, the discharge round entry and the summary carry the same date, and the hospital's by-laws and medical records policy set the completion window the admitting specialist works to.

Where the first GP visit is booked before the patient leaves the ward, the summary is due in the practice inbox before that visit.

Two documents come off the discharge round. The discharge note is the day-of-discharge entry in the inpatient record and stays with the hospital. The GP discharge summary is the letter to the practice, with the summary attached, and it is what Medical Objects carries.

In aurii the discharge round is where both are written. A spoken review at the bedside drafts the discharge note and the GP discharge summary against the patient record, and both wait for sign-off with the round's ward note. Sign-off is the point at which the summary leaves, so the specialist who signs on the round sends the summary on the day of discharge.

The Standard treats discharge as clinical handover. Its handover actions read directly onto the discharge summary.

The Medical Board of Australia's Good Medical Practice code carries the same obligation for the individual doctor. It asks the doctor handing over to make sure the receiving practitioner has the information needed to continue the patient's care. For a private admission the signed summary and its delivery status are the record of that handover.

The summary is drafted from the admission's notes, letters and results held on the patient record. The eight elements and the part of the record each is drawn from are at What a discharge summary must contain.

The GP discharge summary letter draws the admission, the hospital course, the discharge details and the follow-up ask from the same record. Its follow-up block asks for review in the GP's rooms and points the practice to the attached summary for the agreed actions. The specialist edits the draft and signs, and the clinical content is the specialist's.

The GP on the patient record is the recipient. The practice is named on admission, so the recipient is set before the discharge round. aurii checks that the practice is routable on the Medical Objects network before dispatch and refuses a dispatch to a practice that is not, so the clinician chooses another route for that practice before signing.

A practice that is not on the Medical Objects network can receive the summary by email from aurii's own sending address. Email is not a secure-messaging channel, and the clinician chooses it per recipient. The mechanics, and the practice systems reachable on the network, are at Integrations.

The content checks before signing are at What a discharge summary must contain.

Start from the GP discharge summary template for the letter that goes to the practice with the summary attached.

• The recipient is the patient's usual GP at the practice named on admission, and the practice is routable on Medical Objects.
• Where the first GP visit is already booked, the summary is signed before that visit.
• After sign-off, the status against the summary reads acknowledged. A failure is signed off again for resend, and a summary that has not returned an acknowledgement is followed up with the practice.