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Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department
BACKGROUND: Emergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change. METHODS: We performed a prospe...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862093/ https://www.ncbi.nlm.nih.gov/pubmed/29581808 http://dx.doi.org/10.14740/jocmr3375w |
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author | Dahlquist, Robert T. Reyner, Karina Robinson, Richard D. Farzad, Ali Laureano-Phillips, Jessica Garrett, John S. Young, Joseph M. Zenarosa, Nestor R. Wang, Hao |
author_facet | Dahlquist, Robert T. Reyner, Karina Robinson, Richard D. Farzad, Ali Laureano-Phillips, Jessica Garrett, John S. Young, Joseph M. Zenarosa, Nestor R. Wang, Hao |
author_sort | Dahlquist, Robert T. |
collection | PubMed |
description | BACKGROUND: Emergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change. METHODS: We performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented. The primary endpoint was patient length of stay (LOS). A comparative analysis of differences between patient LOS and various handoff communication methods were assessed pre- and post-intervention. Communication methods were entered a multivariable logistic regression model independently as risk factors for patient LOS. RESULTS: The final analysis included 1,006 patients, with 327 comprising the pre-intervention and 679 comprising the post-intervention populations. Bedside rounding occurred 45% of the time without a standard reporting during pre-intervention and increased to 85% of the time with the use of a standard reporting system in the post-intervention period (P < 0.001). Provider time (provider-initiated care to patient care completed) in the pre-intervention period averaged 297 min, but decreased to 265 min in the post-intervention period (P < 0.001). After adjusting for other communication methods, the use of a standard reporting system during handoff was associated with shortened ED LOS (OR = 0.60, 95% CI 0.40 - 0.90, P < 0.05). CONCLUSIONS: Standard reporting system use during emergency physician handoffs at shift change improves ED throughput efficiency and is associated with shorter ED LOS. |
format | Online Article Text |
id | pubmed-5862093 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-58620932018-03-26 Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department Dahlquist, Robert T. Reyner, Karina Robinson, Richard D. Farzad, Ali Laureano-Phillips, Jessica Garrett, John S. Young, Joseph M. Zenarosa, Nestor R. Wang, Hao J Clin Med Res Original Article BACKGROUND: Emergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change. METHODS: We performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented. The primary endpoint was patient length of stay (LOS). A comparative analysis of differences between patient LOS and various handoff communication methods were assessed pre- and post-intervention. Communication methods were entered a multivariable logistic regression model independently as risk factors for patient LOS. RESULTS: The final analysis included 1,006 patients, with 327 comprising the pre-intervention and 679 comprising the post-intervention populations. Bedside rounding occurred 45% of the time without a standard reporting during pre-intervention and increased to 85% of the time with the use of a standard reporting system in the post-intervention period (P < 0.001). Provider time (provider-initiated care to patient care completed) in the pre-intervention period averaged 297 min, but decreased to 265 min in the post-intervention period (P < 0.001). After adjusting for other communication methods, the use of a standard reporting system during handoff was associated with shortened ED LOS (OR = 0.60, 95% CI 0.40 - 0.90, P < 0.05). CONCLUSIONS: Standard reporting system use during emergency physician handoffs at shift change improves ED throughput efficiency and is associated with shorter ED LOS. Elmer Press 2018-05 2018-03-16 /pmc/articles/PMC5862093/ /pubmed/29581808 http://dx.doi.org/10.14740/jocmr3375w Text en Copyright 2018, Dahlquist et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Dahlquist, Robert T. Reyner, Karina Robinson, Richard D. Farzad, Ali Laureano-Phillips, Jessica Garrett, John S. Young, Joseph M. Zenarosa, Nestor R. Wang, Hao Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title | Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title_full | Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title_fullStr | Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title_full_unstemmed | Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title_short | Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department |
title_sort | standardized reporting system use during handoffs reduces patient length of stay in the emergency department |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862093/ https://www.ncbi.nlm.nih.gov/pubmed/29581808 http://dx.doi.org/10.14740/jocmr3375w |
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