ReviewBMJ open2019
Improving best practice for patients receiving hospital discharge letters: a realist review.
Review in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improving communication of prognostic uncertainty in advanced illness: a realist review.BMJ open · 2026Pooled it
- Evaluating the impact of easy-to-understand patient letters after discharge on patients' health literacy: a randomized controlled study.BMC health services research · 2025Trial
- Effect of integrated medicines management on quality of discharge medication information-a secondary endpoint in a randomized controlled trial.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Trial
- How well do we write for patients? Longitudinal analysis of the readability and complexity of 4.6 million ophthalmic clinical letters.BMJ health & care informatics · 2026Article
- One template does not fit all: where next to improve hospital discharge communication to primary care?Primary health care research & development · 2025Article
- Evaluation of a large language model to simplify discharge summaries and provide cardiological lifestyle recommendations.Communications medicine · 2025Article
- In which context and for whom can interventions improve leadership of surgical trainees, surgeons and surgical teams and why: a realist review protocol.NIHR open research · 2023Article
- Article
- Communication of palliative care needs in discharge letters from hospice providers to primary care: a multisite sequential explanatory mixed methods study.BMC palliative care · 2022Article
- Article
- Establishing best practices in cancer online support groups: protocol for a realist review.BMJ open · 2021Article
- Article
- Understanding the positive outcomes of discharge planning interventions for older adults hospitalized following a fall: a realist synthesis.BMC geriatrics · 2021Article
- Can We All Speak the Same 'Language' for Our Patients' Sake? Feedback on Interprofessional Communication and Related Resources.Global advances in health and medicine · 2021Article
- Adult patient perspectives on receiving hospital discharge letters: a corpus analysis of patient interviews.BMC health services research · 2020Article
- Making hospital discharge safer for frail older patients.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Article
- The Discharge Communication Study: research protocol for a mixed methods study to investigate and triangulate discharge communication experiences of patients, GPs, and hospital professionals, alongside a corresponding discharge letter sample.BMC health services research · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo understand how different outcomes are achieved from adult patients receiving hospital discharge letters from inpatient and outpatient settings.
designRealist review conducted in six main steps: (1) development of initial theory, (2) searching, (3) screening and selection, (4) data extraction and analysis, (5) data synthesis and (6) programme theory (PT) refinement. ELIGIBILITY CRITERIA: Documents reporting evidence that met criteria for relevance to the PT. Documents relating solely to mental health or children aged <18 years were excluded. ANALYSIS: Data were extracted and analysed using a realist logic of analysis. Texts were coded for concepts relating to context, mechanism, outcome configurations (CMOCs) for the intervention of patients receiving discharge letters. All outcomes were considered. Based on evidence and our judgement, CMOCs were labelled 'positive' or 'negative' in order to clearly distinguish between contexts where the intervention does and does not work.
results3113 documents were screened and 103 were included. Stakeholders contributed to refining the PT in step 6. The final PT included 48 CMOCs for how outcomes are affected by patients receiving discharge letters. 'Patient choice' emerged as a key influencer to the success (or not) of the intervention. Important contexts were identified for both 'positive' CMOCs (eg, no new information in letter) and 'negative' CMOCs (eg, letter sent without verifying patient contact details). Two key findings were that patient understanding is possibly greater than clinicians perceive, and that patients tend to express strong preference for receiving letters. Clinician concerns emerged as a barrier to wider sharing of discharge letters with patients, which may need to be addressed through organisational policies and direction.
conclusionsThis review forms a starting point for explaining outcomes associated with whether or not patients receive discharge letters. It suggests several ways in which current processes might be modified to support improved practice and patient experience.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.