3188 Improved discharge summaries for older patients: a step toward better continuity of care with comprehensive geriatric assessment

Abstract Introduction Effective communication between primary and secondary care teams is essential for providing continuity of care in the community for older people with frailty. Discharge summaries often lack information captured in a comprehensive geriatric assessment (CGA). Junior members of the team, tasked with writing discharge letters, have not been formally taught in this area. This project aimed to incorporate key CGA domains into discharge summaries. Methods The geriatric medicine department at Broomfield Hospital and community mid virtual frailty team identified 7 core CGA domains for discharge summaries: main diagnosis, DNAR (Do Not Attempt Resuscitation) status, clinical frailty score (CFS), mobility/functional assessment, cognition, psychological concerns, and medications review. The project was piloted on a 26-bed ward, with data collected from patients over 65 years discharged. Audits were conducted across three cycles between October 2023 and November 2024. A total of 42 patients in cycle 1 and 2, and 50 patients in cycle 3 were included, excluding deaths. Initial interventions involved delivering an educational session and placing a poster. For the third cycle, additional measures were introduced: appointing two resident doctors as project champions and displaying an example discharge summary template. Weekly review of discharge summaries for 7 weeks, with weekly feedback was also implemented. Results Baseline audit showed low compliance with CGA in discharge summaries. By cycle 3, significant improvements were observed: main diagnosis and medications review were fully documented (100%), CFS documentation increased to 75%, and mobility/functional assessment (37%), cognition (38%), and psychological concerns (38%) showed notable progress. However, DNAR status documentation decreased from 81% to 75%. Feedback from doctors was positive, with the new template considered straightforward. Conclusion The project successfully improved CGA documentation in discharge summaries. Future proposals include expanding the initiative to other wards and integrating a modified template into the electronic discharge system for easier access.