Effect of a Handover Tool on Efficiency of Care and Mortality for Interhospital Transfers
| Autor: | Jesse M. Ehrenfeld, Sunil Kripalani, Neesha N. Choma, Cecelia Theobald, Stephan Russ |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Patient Transfer Time Factors Leadership and Management Population MEDLINE Assessment and Diagnosis 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Health care Outcome Assessment Health Care Medicine Humans 030212 general & internal medicine Hospital Mortality education Care Planning Retrospective Studies education.field_of_study business.industry Health Policy Mortality rate 030208 emergency & critical care medicine Retrospective cohort study General Medicine Odds ratio Length of Stay medicine.disease Confidence interval Hospital medicine Hospitalization Fundamentals and skills Female Medical emergency business |
| Zdroj: | Journal of hospital medicine. 12(1) |
| ISSN: | 1553-5606 |
| Popis: | Background Interhospital transfer is frequent, and transferred patients experience delays in the provision of care and higher mortality rates when compared to patients directly admitted. The interhospital handover is a key opportunity to improve care but has not been evaluated. Objective To determine the effect of a universal handover tool on timeliness of care, length of stay (LOS), and mortality among interhospital transfer patients. Design, setting, and patients Retrospective cohort of patients transferred to an academic medical center between July 1, 2009 and December 31, 2010 with interrupted time-series design. Intervention One-page handover tool containing information critical for immediate patient care instituted hospital-wide on July 1, 2010. The handover tool was completed by the transferring physician and available for review before patient arrival. Measurements Time-to-admission order entry, LOS after transfer, in-hospital mortality. Results There was no significant change in the time-to-admission order entry after implementation (47 minutes vs. 45 minutes, adjusted P = 0.94). There was a nonstatistically significant reduction in LOS after implementation (6.5 days vs. 5.8 days, adjusted P = 0.06). In-hospital mortality for transfer patients declined significantly in the postintervention period from 12.0% to 8.9% (adjusted odds ratio, 0.68; 95% confidence interval, 0.47 - 0.99, P = 0.04). There was no change in mortality for the concurrent control group. Conclusion Implementation of a standardized handover tool for interhospital transfer was feasible and may be associated with significant reductions in length of stay and mortality. Widespread adoption of similar tools may improve outcomes in this high-risk population. Journal of Hospital Medicine 2017;12:23-28. |
| Databáze: | OpenAIRE |
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