[Quality of hospital emergency department discharge summaries to general practitioners].

Introduction: Improvement of the quality of exchanges between primary care and hospital medicine is a major challenge for continuity of care in France. The objective of this study was to evaluate the quality of communication of information to general practitioners concerning the management of patients attending a university hospital emergency department.

Materials And Methods: This retrospective study was based on the medical charts of 602 patients consulting the Angers university hospital emergency department, using an evaluation grid of discharge summaries associated with a survey of general practitioners, by postal questionnaire, concerning the time to reception, the content and the mode of transmission of these discharge summaries.

Results: Strong points were patient identification, the visit date, the presence of complementary imaging investigation results and the presence of a conclusion. Weak points and aspects requiring improvement were identification of the emergency physician, indicated in only 48% of discharge summaries, notification of the previous treatment absent in 93% of cases, the treatment received in the emergency department and on discharge was absent or incomplete in 78% and 92% of discharge summaries, respectively, follow-up advice was provided in 36% of cases and the information given to the patient was indicated in 16% of discharge summaries. The time to reception of discharge summaries was < or = 48 hours in 8.5% of cases and < or = one week in 99% of cases. General practitioners were satisfied with the content (90%) and the form (84%) of emergency department discharge summaries; however, they would like to receive better structured and more concise discharge summaries, preferably sent by secure e-mail for 62% of them.

Conclusion: Standardization of discharge summaries, adapted to the general practitioner's practice, given directly to the patient and sent by secure e-mail appear to be one of the main targets for improvement of the quality of management to be introduced in hospital emergency departments.