Development of Grapho-Narrative Neonatal Discharge Summary Format and its Comparison with Traditional Narrative Format

Background Tiny and sick neonates stay for a longer duration in the Neonatal unit. Discharge of these neonates gets quite delayed due to typing the elaborative summary followed by other discharge formalities. This results in unpleasant experiences for most parents and some of them express the displeasure quite vocally. Apart from that, the presentation of crucial information is not uniform due to the variable levels of experience and language proficiency of the doctors who prepare discharge summaries. Primary Objective To develop a graphical format of discharge summary for neonatal patients and compare it with a traditional narrative discharge summary. Method In this study, we developed a Microsoft Excel template for a visual representation of main discharge information with scope for narration when required. We compared this with the traditional narrative summary of a hypothetical case. Results 20 pediatricians with experience in neonatal intensive care participated and filled in the scorecard after going through both formats of the discharge summary. Overall, the grapho-narrative summary scored significantly better with a median score of 114 compared to narrative summary score of 90 (p=.004). Conclusion Grapho-narrative format is quicker to prepare, provides the information as a snapshot which is preferred by pediatricians.