Improved Patient Handoffs to Prevent Sentinel Events
| Status: | Not yet recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/3/2014 |
| Contact: | Christopher O'Donnell, MD |
| Email: | christopher.odonnell@duke.edu |
| Phone: | 919-470-8490 |
Patient Acuity Score With Improved Patient Handoffs to Prevent Sentinel Events
The overall aim of this project is to improve the quality of the handoffs between
hospitalists on the general medicine service at Durham Regional Hospital with the intent of
improving transitions of care. The intervention will be an improved and more structured
face to face sign-out process using a standardized admission sign-out sheet, which is not
part of the official medical record. Daytime admitting physicians will assign an acuity
score to their patients in which the severity of illness will be scored from 1-7, with 7
being the most sick / likely to have rapid response team (RRT) or adverse event. The
assignment of this score would be based off of the clinician's judgment in the patient's
overall assessment. All patients, age >18 years, admitted to the non-resident hospital
medicine general medicine service at DRH will be study eligible. Data analysis will examine
aggregate hospitalist perception of sign-out practice before and after intervention, total
number of RRTs, unplanned transfers, and rapid responses pre and post intervention,
percentage of hospitalist based patients of overall rapid responses pre and post
intervention, percentage of hospitalists using acuity scores, and average and mean severity
score of patients with rapid responses compared with those admitted. Patients have a risk
of loss of confidentiality.
hospitalists on the general medicine service at Durham Regional Hospital with the intent of
improving transitions of care. The intervention will be an improved and more structured
face to face sign-out process using a standardized admission sign-out sheet, which is not
part of the official medical record. Daytime admitting physicians will assign an acuity
score to their patients in which the severity of illness will be scored from 1-7, with 7
being the most sick / likely to have rapid response team (RRT) or adverse event. The
assignment of this score would be based off of the clinician's judgment in the patient's
overall assessment. All patients, age >18 years, admitted to the non-resident hospital
medicine general medicine service at DRH will be study eligible. Data analysis will examine
aggregate hospitalist perception of sign-out practice before and after intervention, total
number of RRTs, unplanned transfers, and rapid responses pre and post intervention,
percentage of hospitalist based patients of overall rapid responses pre and post
intervention, percentage of hospitalists using acuity scores, and average and mean severity
score of patients with rapid responses compared with those admitted. Patients have a risk
of loss of confidentiality.
Inclusion Criteria:
- patients age >18 years
- admitted to the non-resident hospital medicine general medicine service at Durham
Regional Hospital (DRH). (This would include transfers from outside hospital, the
Emergency Room, intensive care units, and the Durham Rehab Institute.)
- Additionally, hospital medicine faculty who round on the non-resident general
medicine service at DRH will be included for the purposes of completion of perception
surveys.
Exclusion Criteria:
- Patients presenting for consults, rapid responses handled by surgical services and
rapid responses as reason for transfer from Durham Rehabilitation Institute.
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