TY - JOUR
T1 - Handoff Tool Enabling Standardized Transitions Between the Emergency Department and the Hospitalist Inpatient Service at a Major Cancer Center
AU - Gonzalez, Carmen E
AU - Brito-Dellan, Norman
AU - Banala, Srinivas R.
AU - Rubio, David
AU - Ait Aiss, Mohamed
AU - Rice, Terry W
AU - Chen, Karen
AU - Bodurka, Diane C
AU - Escalante, Carmelita P
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution’s ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers. Comparison of preintervention and postintervention results from the 1-month pilot revealed that within a 24-hour period, DE-PASS reduced the number of intensive care unit transfers by 58% (P =.393), the number of rapid-response team calls by 39% (P =.637), and time to inpatient order by 31% (P =.004). ED physicians’ and hospitalists’ satisfaction with DE-PASS increased. Reduction in intensive care unit transfers was sustained after the pilot (P =.029). DE-PASS feasibility was evidenced by 100% uptake. By stratifying patients by risk level, DE-PASS reduced admission-to-evaluation times for unstable patients, potentially improving patient safety.
AB - Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution’s ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers. Comparison of preintervention and postintervention results from the 1-month pilot revealed that within a 24-hour period, DE-PASS reduced the number of intensive care unit transfers by 58% (P =.393), the number of rapid-response team calls by 39% (P =.637), and time to inpatient order by 31% (P =.004). ED physicians’ and hospitalists’ satisfaction with DE-PASS increased. Reduction in intensive care unit transfers was sustained after the pilot (P =.029). DE-PASS feasibility was evidenced by 100% uptake. By stratifying patients by risk level, DE-PASS reduced admission-to-evaluation times for unstable patients, potentially improving patient safety.
KW - communications
KW - emergency department
KW - hospitalist
KW - nocturnalist
KW - patient handoff
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U2 - 10.1177/1062860618776096
DO - 10.1177/1062860618776096
M3 - Article
C2 - 29779398
AN - SCOPUS:85047422068
SN - 1062-8606
VL - 33
SP - 629
EP - 636
JO - American Journal of Medical Quality
JF - American Journal of Medical Quality
IS - 6
ER -