From uncertainty to confidence: A quality improvement project on improving safety netting in discharge summaries
Introduction: Inconsistent safety netting advice in discharge summaries can leave patients unsure of when to seek further medical attention, increasing the risk of delayed care. Junior doctors often struggle with providing clear, structured safety netting, leading to variability and inefficiencies....
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Future Healthcare Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S251466452500181X |
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| Summary: | Introduction: Inconsistent safety netting advice in discharge summaries can leave patients unsure of when to seek further medical attention, increasing the risk of delayed care. Junior doctors often struggle with providing clear, structured safety netting, leading to variability and inefficiencies. This quality improvement project (QIP) aimed to develop and implement a standardised safety netting template for common conditions in an acute medicine setting.As a first-year doctor, I found safety netting particularly challenging. I lacked confidence that I was providing the right advice, and the fear of missing something critical was daunting. Poorly structured safety netting could mean patients either delayed seeking urgent care or accessed healthcare inappropriately due to unclear instructions. I realised that having a structured approach could provide reassurance and consistency, especially for new doctors. I hypothesised that a standardised template could support junior doctors, streamline documentation, and enhance patient safety. Materials and methods: A baseline audit assessed variability in safety netting documentation across discharge summaries. A structured template covering 12 common conditions (Figs 1 and 2), such as chest pain, dizziness, and headaches, was developed and introduced. An easily accessible web link was provided to doctors (www.tinyurl.com/gpausn), where the templates could be accessed. This allowed for easy copying and pasting of the appropriate safety netting advice directly into discharge summaries, depending on the condition. Doctors completed pre- and post-implementation surveys assessing confidence, professional satisfaction and time efficiency. A second-cycle audit measured improvements in documentation quality and consistency. Results and discussion: The implementation of standardised safety netting templates led to a marked improvement in doctors’ confidence, with 85% of respondents reporting a confidence level of 5, compared to a pre-intervention range of 2–4. This shift highlights the templates’ effectiveness in providing clarity and reducing uncertainty in patient follow-up.In terms of professional satisfaction, the templates proved highly beneficial, with 71% of doctors rating their satisfaction at the highest level (5). This demonstrates that the structured approach not only increased confidence, but also reassured doctors, enabling more effective safety netting and follow-up.Furthermore, the templates resulted in significant time savings. 86% of respondents reported the highest rating (5) for time efficiency, reflecting the streamlined process that reduced the need for repeated revisions. These efficiency gains allowed doctors to complete discharge summaries more quickly, without compromising the quality of safety netting advice, thus improving both patient care and documentation accuracy. Conclusion: Standardising safety netting in discharge summaries significantly improved clarity, consistency and efficiency, while boosting doctor confidence and professional satisfaction. The templates have been shown to enhance the quality of patient care, providing reassurance for both patients and doctors. Future steps include hospital-wide poster displays, expanding the template to additional conditions, and integrating drop-down options into the digital discharge system to further optimise discharge processes and patient safety. |
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| ISSN: | 2514-6645 |