Table 3.

Study participants recommended strategies on improving communication between the treating hospital and PHC services.

Themes	Participants recommendations	Sample Hospital participant quotes	Sample PHC participant quotes
Shared patient records/care plans, use of technology	Hospital and PHC: Increase use of phone calls to discuss patient care in timely manner, more timely information exchange, sharing of electronic patient records and use of other technology (e.g. telehealth, teleconferences) to discuss patient care in a timely manner. PHC: Prompt follow-up of urgent concerns, clearly documented and shared cancer treatment and management plans.	“It’s about timeliness of the delivery of information and I do think that often there’s an unacceptable delay between the patient’s diagnosis and the GP getting the information, because the patients have very commonly been back to see their GP before the GP has received a letter from us.” (Hospital 6, Non-Indigenous specialist)	“So, maybe if it’s consented (to share patient’s hospital records) when they (patients’) first go in… then after that’s fine. So, if paperwork has come, then they can just send it straight through… if the consent is given for the doctor to share the paperwork while our patient is still in hospital, then that might be a good thing too… because then too once again… if a doctors have got a heads up about what’s happening and what needs to be done when the patient comes out, and then they can start to organise that before they come out.” (PHC 8, Indigenous EEN)
Working collaboratively, clarity around follow-up care	Hospital and PHC: Having a designated contact person at each site and associated contact phone number for health professionals to contact to discuss patients care. PHC: Clarity around post-hospital discharge follow-up care (e.g. who is doing what and when), development of agreed communication protocols and processes between services, regular face-to-face meetings to discuss patient care/needs and collaborative action to address/support patients prior to hospital discharge. Hospital: Hospital ALO’s to engage in more community engagement activities with PHC services and community, ensuring hospital has correct GP contact details for communication	“I know at one point there we were doing a lot of community engagement so we were able to actually leave the hospital and go and visit organisations and things, but we kind of cut back on that community engagement. I suppose if we returned to that level of community engagement again that would probably help.” (Hospital 8, Indigenous ALO)	(Regarding discharge summary paperwork) “there’s actually someone (named on discharge summary) that can be contacted … so, for instance I may not know who the registrar is, and within Queensland Health they will change during a year, so for there to be a named individual on the discharge summary that says, ‘if you’ve got any questions please phone blah blah blah, and here is my mobile number’, so that there’s a named point of contact.” (PHC 3, Non-Indigenous care coordinator RN)
Notifications/updates around hospitalisations, accurate GP details	PHC: Notification from hospital to inform treating PHC of patient admission, discharge and regular updates on patient condition during hospitalisation. Hospital: having updated treating GP information for the patient.	“Again, it will come down to as long as we’ve got the right GP and that the patient is going back there. I think if we see a patient and we get them through the process and treat them, we make sure that we explain to them as best we can what the recovery is going to be, we do a follow-up phone call which I do… and then send those letters to the GP. I think that’s pretty good communication and always know or trusting that a Doctor would call if they need to.” (Hospital 5, Non-Indigenous RN)	“It’s just… I spose ongoing communication. What I’d like to see is more information about patients who are in the hospital… so we know who is in the hospital. Whether they’re in there for… say they got sick at home and they’re now in having treatment at palliative care. I’d like to know about all our patients… all Aboriginal patients that may be in palliative care. I’d like to know as soon as… not wait two weeks down the track.” (PHC 9, Non-Indigenous social worker)
More efficient administrative processes	PHC: Hospital obtaining patients signed consent once (rather than multiple times) to release hospital treatment records to the treating PHC. Hospital: Reducing the turnaround time for hospital specialist letters to be dictated and sent to GPs, use of electronic systems	“We need to be emailing these letters and they need to be going electronically to GP’s, but at an administrative level.., I think that we need to improve those communication pathways, and it needs to be electronic.. but then, there’s still this delay in the dictation process.” (Hospital 6, Non-Indigenous specialist)	“Oh, it’s just I suppose it’s just the feedback. When they’ve seen the specialist you need to have that feedback from the specialist. It’s just this paperwork that you need to chase up all the time. Especially when they get into those big hospitals.” (PHC 13, Non- Indigenous EEN)