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Is failure to act on discharge summaries causing harm in general practice?

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Review of: Spencer RA et al. Processing of discharge summaries in general practice: a retrospective record review. Br J Gen Pract 2018;68:e576–85.

Key learning points

  • A review of 300 patient records found that follow-up actions were not completed in almost half (46%) of all discharge summaries.

  • Harms occurred in 8% of cases in which changes to discharge summaries were not made, most of which were of moderate severity.

  • High severity harms included progression of chronic kidney disease, subsequent hospitalisations from heart failure and chronic obstructive pulmonary disease and a potentially preventable death from pneumonia.

A retrospective review of hospital discharge summaries showed that requested actions were not fulfilled in almost half of all cases, which led to harm to patients in 8% of these cases.


This retrospective review assessed 300 discharge summaries from 10 general …

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  • Provenance and peer review Commissioned; internally peer reviewed.

  • Contributors DTB Team.