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Deployed communication between the Role 3 and Role 1
  1. Iain T Parsons
  1. Correspondence to Capt Iain T Parsons, General Duties Medical Officer, 5 Medical Regiment, Gaza Barracks, Catterick Garrison, Catterick DL94DP, UK; iainparsons{at}


Introduction The discharge summary is the most common method for documenting a patient's diagnostic findings, hospital management and arrangements for post-discharge follow up. After being discharged from hospital, patients are routinely reviewed without a discharge summary being available. A recent review revealed that a significant proportion of patients discharged from the Role 3 had no evidence of their admission on their permanent medical record. The aim of this audit was to assess the transition of discharge summaries from Role 3 to Role 1 during Op HERRICK 18. The intention was to review where errors in the transfer of discharge information between Role 3 and Role 1 might be occurring with a view to implementing improvements.

Methods Two audits assessed the delivery of discharge information. A re-audit was performed 1 month after a system was implemented.

Results The transfer of discharge information was poor with only 1/40 (2.5%) summaries arriving from R3 to R1. Following implementation of a system the transfer of discharge information improved to 24/30 (80%).

Conclusions The adoption of a system to transit discharge information from R3 to R1 resulted in a drastic improvement. Ideally, a future electronic patient record system used by all facets of Defence Medical Services would limit the potential for future adverse events due to communication failure. Regular audits assessing the transfer of discharge information should form part of standard audit cycles in future contingency operations.

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