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  1. Harun NA, Finlay AY, Salek M, Piguet V
    Br J Dermatol, 2016 Sep;175(3):572-82.
    PMID: 27060980 DOI: 10.1111/bjd.14650
    BACKGROUND: Although multiple factors influence discharge decisions, there is no structured guidance to assist clinicians in making informed decisions. A discharge information checklist might improve the appropriateness of dermatology clinicians' discharge decisions.

    OBJECTIVES: To generate consensus among dermatologists on the content of an outpatient discharge checklist, to create one and to seek clinicians' opinions on its usefulness.

    METHODS: Seventeen consultant dermatologists from five National Health Service trusts completed a 72-item Delphi questionnaire. A five-point Likert scale was used to rate each item for importance in contributing to a high-quality discharge decision. Eighteen clinicians completed a questionnaire evaluating checklist use.

    RESULTS: Consensus was determined when ≥ 75% of consultants rated an item 'very important' or 'important'. There was strong inter-rater reliability (intraclass correlation coefficient = 0·958) and fair inter-rater agreement (Fleiss kappa = 0·269). There were 26 consensus-agreed items, condensed to 13 that formed the 'traffic-light' checklist. These are disease-related issues (diagnostic certainty, disease severity, treatment appropriateness, patient manageable in primary care, patient's benefit from follow-up), patient empowerment issues (understanding diagnosis and treatment outcome, having a clear plan, treatment side-effects, ability to self-manage) and addressing concerns (patient concerns, easy reaccess to secondary care, whether patient and clinician are happy with the decision). Twelve clinicians (67%) found the checklist useful, 11 (61%) wanted to use it in future, 10 (56%) thought it was useful for training and three (17%) said it helped their thinking. Clinicians suggested its use for auditing and for training clinicians and administrators.

    CONCLUSIONS: Items were identified to create an outpatient discharge information checklist, which demonstrated high acceptability.

    Matched MeSH terms: Dermatologists/psychology
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