P107 Improving discharge summary quality through the development of a digital BASL decompensated cirrhosis discharge bundle in a regional liver unit

<h3>Introduction</h3> The prevalence of decompensated liver cirrhosis as a cause of hospital admission has risen significantly since 1990. Despite the availability of the BASL decompensated cirrhosis discharge bundle, national uptake remains low. Prior studies suggest that the use of the bundle can improve care standards and reduce preventable readmissions. This quality improvement project aimed to assess whether integrating a digital version of the discharge bundle into the discharge process improves documentation quality. Our aim was for 90% of discharge letters to include a completed bundle. <h3>Methods</h3> For baseline data we retrospectively assessed discharge summaries on an electronic health records system for patients admitted with decompensated cirrhosis to the Northern Ireland Regional Liver Unit in March 2025. Patients who died during admission or were discharged for palliative care were excluded. A digital version of the BASL discharge bundle was embedded into the electronic discharge template and made accessible via a smart phrase. Resident doctors received training on its use during induction as the initial intervention. Following the initial intervention of training, data was collected for April 2025 using the same criteria. <h3>Results</h3> 24 decompensated cirrhosis admissions were included as the baseline, with 18 admissions in the first period following initial intervention. Following the first PDSA cycle, 16/18 (88.9%) of discharge letters included the digital bundle. There was a trend towards improved completion rate of all checklist items. Documentation of liver disease aetiology (17/24 (70.8%) vs 18/18 (100%), p=0.0365), discharge weight (1/24 (4.2%) vs 4/18 (77.8%), p=0.0001), discharge U&amp;E results (2/24 (8.3%) vs 15/18 (83.3%), p=0.0001) and planning for future U&amp;E monitoring (6/24 (25.0%) vs 12/18 (66.7%), p=0.0171) all improved significantly as a result of the creation and roll out of the digital BASL decompensated cirrhosis discharge bundle. <h3>Conclusion</h3> The implementation of a digital discharge bundle significantly improved the quality and completeness of discharge documentation for patients with decompensated liver cirrhosis. Ongoing quality improvement cycles are planned to further enhance outcomes and promote consistent use. <h3>References</h3> Sepanlou SG, <i>et al. Lancet Gastroenterol Hepatol.</i> 2020;5(3):245–266. doi:10.1016/s2468–1253(19)30349–8 Khaliq MJ, Townsend S, Nair A. <i>Gut</i> 2023. doi:10.1136/gutjnl-2023-bsg.88 Zuhaid M, <i>et al. Clin Med.</i> 2022;22(4):77. doi:10.7861/clinmed.22–4-s77