Improving the Quality of Discharge Summaries in the Stroke Department : A Clinical Quality Improvement Project

Background:

For safe stroke care, comprehensive discharge summary reports are essential. They always can assure promote continuous secondary stroke prevention, facilitate communication between hospital and local community teams, and reduce the chance of possible readmission. In this Quality Improvement Project (QIP), we examined Queen's Hospital's stroke discharge summaries and compared them to the BHRUT local discharge policy and the Royal College of Physicians Stroke Discharge Guidelines (2023).

Methods:

In these two audit cycles, Cycle 1 done in May 2024 and Cycle 2 in October 2025, we reviewed fifty stroke discharge summaries. Five categories of data were examined using a standardised form: Admission and Examination, Imaging and Blood Results, Hospital Progress and Cardiology input, Discharge Criteria, and finally Patient/Family Education. For each category, we aim for 90% compliance. Following Cycle 1, we provided focused education, collected staff input, and implemented discharge checklists. The results from both cycles were analysed and compared using Microsoft Excel.

Results:

In three of the five categories, we observed improved documentation. Patient/family advice increased from 20% to 32%, discharge criteria from 44% to 48%, and admission and examination from 30% to 55%. However, compliance decreased from 88% to 72% for Hospital Progress and Cardiology and from 100% to 69% for Imaging (Neuro and Vascular).

Conclusion:

Certain aspects of stroke discharge documentation, particularly admission evaluation and patient or family communication, were enhanced by targeted modifications. Checklists alone, however, are unable to meet high standards, as seen by persistent and emerging gaps in imaging and cardiology documentation. We should employ the electronic records, promote greater interdisciplinary collaboration, and uphold stroke-specific discharge guidelines with frequent monitoring and continuous QIP cycles in order to further improve.