Interdisciplinary videoconference model for identifying potential adverse transition of care events following hospital discharge to postacute care.

Autor:	Beiter ER; Stanford University School of Medicine, Stanford, California, USA., Shanbhag A; Signature Healthcare, Brockton, Massachusetts, USA., Junge-Maughan L; Nuvance Health, Lagrangeville, New York, USA., Knoph K; Pharmacy, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Dufour AB; Harvard Medical School, Boston, Massachusetts, USA.; Hinda and Arthur Marcus Institute for Aging Research, Boston, Massachusetts, USA., Lipsitz L; Harvard Medical School, Boston, Massachusetts, USA.; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Moore A; Harvard Medical School, Boston, Massachusetts, USA AMOORE21@mgh.harvard.edu.; Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2024 May 24; Vol. 13 (2). Date of Electronic Publication: 2024 May 24.
DOI:	10.1136/bmjoq-2023-002508
Abstrakt:	Discharge from hospitals to postacute care settings is a vulnerable time for many older adults, when they may be at increased risk for errors occurring in their care. We developed the Extension for Community Healthcare Outcomes-Care Transitions (ECHO-CT) programme in an effort to mitigate these risks through a mulitdisciplinary, educational, case-based teleconference between hospital and skilled nursing facility providers. The programme was implemented in both academic and community hospitals. Through weekly sessions, patients discharged from the hospital were discussed, clinical concerns addressed, errors in care identified and plans were made for remediation. A total of 1432 discussions occurred for 1326 patients. The aim of this study was to identify errors occurring in the postdischarge period and factors that predict an increased risk of experiencing an error. In 435 discussions, an issue was identified that required further discussion (known as a transition of care event), and the majority of these were related to medications. In 14.7% of all discussions, a medical error, defined as 'any preventable event that may cause or lead to inappropriate medical care or patient harm', was identified. We found that errors were more likely to occur for patients discharged from surgical services or the emergency department (as compared with medical services) and were less likely to occur for patients who were discharged in the morning. This study shows that a number of errors may be detected in the postdischarge period, and the ECHO-CT programme provides a mechanism for identifying and mitigating these events. Furthermore, it suggests that discharging service and time of day may be associated with risk of error in the discharge period, thereby suggesting potential areas of focus for future interventions. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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