Patient care transitions from the emergency department to the medicine ward: evaluation of a standardized electronic signout tool.
Int J Qual Health Care
; 26(4): 337-47, 2014 Aug.
Article
em En
| MEDLINE
| ID: mdl-24737836
ABSTRACT
OBJECTIVE:
To evaluate the impact of a new electronic handoff tool for emergency department to medicine ward patient transfers over a 1-year period.DESIGN:
Prospective mixed-methods analysis of data submitted by medicine residents following admitting shifts before and after eSignout implementation.SETTING:
University-based, tertiary-care hospital.PARTICIPANTS:
Internal medicine resident physicians admitting patients from the emergency department. INTERVENTION An electronic handoff tool (eSignout) utilizing automated paging communication and responsibility acceptance without mandatory verbal communication between emergency department and medicine ward providers. MAIN OUTCOMEMEASURES:
(i) Incidence of reported near misses/adverse events, (ii) communication of key clinical information and quality of verbal communication and (iii) characterization of near misses/adverse events.RESULTS:
Seventy-eight of 80 surveys (98%) and 1058 of 1388 surveys (76%) were completed before and after eSignout implementation. Compared with pre-intervention, residents in the post-intervention period reported similar number of shifts with a near miss/adverse event (10.3 vs. 7.8%; P = 0.27), similar communication of key clinical information, and improved verbal signout quality, when it occurred. Compared with the former process requiring mandatory verbal communication, 93% believed the eSignout was more efficient and 61% preferred the eSignout. Patient safety issues related to perceived sufficiency/accuracy of diagnosis, treatment or disposition, and information quality.CONCLUSIONS:
The eSignout was perceived as more efficient and preferred over the mandatory verbal signout process. Rates of reported adverse events were similar before and after the intervention. Our experience suggests electronic platforms with optional verbal communication can be used to standardize and improve the perceived efficiency of patient handoffs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transferência de Pacientes
/
Sistemas de Informação Hospitalar
/
Comunicação
/
Continuidade da Assistência ao Paciente
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Int J Qual Health Care
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2014
Tipo de documento:
Article