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https://www.readbyqxmd.com/read/28202769/project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle
#1
Leah A Mallory, Snezana Nena Osorio, B Stephen Prato, Jennifer DiPace, Lisa Schmutter, Paula Soung, Amanda Rogers, William J Woodall, Kayla Burley, Sandra Gage, David Cooperberg
BACKGROUND AND OBJECTIVES: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates...
February 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28198723/leveraging-telemedicine-infrastructure-to-monitor-quality-of-operating-room-to-intensive-care-unit-handoffs
#2
Mark E Barry, Beth R Hochman, Meghan B Lane-Fall, Denise Zappile, Daniel N Holena, Brian P Smith, Lewis J Kaplan, Ann Huffenberger, Patrick M Reilly, Jose L Pascual
PURPOSE: To analyze in-room video recordings of operating room (OR) to intensive care unit (ICU) handoffs to determine tempo and quality of team interactions on nights and weekends compared with weekdays, and to demonstrate how existing telemedicine technology can be used to evaluate handoffs. METHOD: This prospective observational study of OR-to-ICU bedside handoffs was conducted in the surgical ICU of the Hospital of the University of Pennsylvania in July 2014-January 2015...
February 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28197967/year-end-clinic-handoffs-a-national-survey-of-academic-internal-medicine-programs
#3
Erica Phillips, Christina Harris, Wei Wei Lee, Amber T Pincavage, Karin Ouchida, Rachel K Miller, Saima Chaudhry, Vineet M Arora
BACKGROUND: While there has been increasing emphasis and innovation nationwide in training residents in inpatient handoffs, very little is known about the practice and preparation for year-end clinic handoffs of residency outpatient continuity practices. Thus, the latter remains an identified, yet nationally unaddressed, patient safety concern. OBJECTIVES: The 2014 annual Association of Program Directors in Internal Medicine (APDIM) survey included seven items for assessing the current year-end clinic handoff practices of internal medicine residency programs throughout the country...
February 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#4
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28155017/implementing-standardized-inter-unit-communication-in-an-international-setting-handoff-of-patients-from-emergency-medicine-to-internal-medicine
#5
Kamna S Balhara, Susan M Peterson, Mohamed Moheb Elabd, Linda Regan, Xavier Anton, Basil Ali Al-Natour, Yu-Hsiang Hsieh, James Scheulen, Sarah A Stewart de Ramirez
Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#6
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152929/safer-transitions-of-care-at-a-major-cancer-center-the-emergency-center-to-hospitalist-experience
#7
Carmen E Gonzalez, Norman Brito-Dellan, David Rubio, Mohamed Ait Aiss, Terry Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
: 247 Background: Failures in communication lead to serious medical errors particularly during transitions of care. A standardized handoff of patients requiring admission to the inpatient setting between the Emergency Center (EC) and the Hospitalist Inpatient Service (HIS) at a comprehensive cancer center was lacking during this vulnerable time. METHODS: A quality pilot study using Plan, Do, Study, Act methodology was conducted. First, root cause analysis and process mapping of the current state was performed to identify pitfalls of the handoff process between the EC and the Hospitalist Service...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28131547/ensuring-safe-transfer-of-pediatric-patients-a-quality-improvement-project-to-standardize-handoff-communication
#8
Lindsey J Patton, Jerithea D Tidwell, Karie L Falder-Saeed, Virginia B Young, Brennan D Lewis, Jacqueline F Binder
BACKGROUND: During a single hospital stay, a patient's care is transferred several times between health care clinicians requiring multiple handoffs. Nurses often voice concerns about feeling unsafe when receiving patients from other areas. AIMS: The aims of the intradepartmental quality improvement project were to identify the safest way to transfer care of pediatric patients and to improve bedside nurses' knowledge on conducting an evidence based practice project...
January 25, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28129355/performance-analysis-of-inter-domain-handoff-scheme-based-on-virtual-layer-in-pmipv6-networks-for-ip-based-internet-of-things
#9
Chulhee Cho, Jae-Young Choi, Jongpil Jeong, Tai-Myoung Chung
Lately, we see that Internet of things (IoT) is introduced in medical services for global connection among patients, sensors, and all nearby things. The principal purpose of this global connection is to provide context awareness for the purpose of bringing convenience to a patient's life and more effectively implementing clinical processes. In health care, monitoring of biosignals of a patient has to be continuously performed while the patient moves inside and outside the hospital. Also, to monitor the accurate location and biosignals of the patient, appropriate mobility management is necessary to maintain connection between the patient and the hospital network...
2017: PloS One
https://www.readbyqxmd.com/read/28125824/discharge-handoff-communication-and-pediatric-readmissions
#10
Ryan J Coller, Thomas S Klitzner, Adrianna A Saenz, Carlos F Lerner, Lauren G Alderette, Bergen B Nelson, Paul J Chung
BACKGROUND: Improvement in hospital transitional care has become a major national priority, although the impact on children's postdischarge outcomes is unclear. OBJECTIVE: To characterize common handoff practices between hospital and primary care providers (PCPs), and test the hypothesis that common handoff practices would be associated with fewer unplanned readmissions. DESIGN, SETTING, AND PATIENTS: This prospective cohort study enrolled randomly selected pediatric patients during an acute hospitalization at a tertiary children's hospital in 2012-2014...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28116015/transition-of-care-practices-from-emergency-department-to-inpatient-survey-data-and-development-of-algorithm
#11
Sangil Lee, Jaime Jordan, H Gene Hern, Chad Kessler, Susan Promes, Sarah Krzyzaniak, Fiona Gallahue, Ted Stettner, Jeffrey Druck
INTRODUCTION: We aimed to assess the current scope of handoff education and practice among resident physicians in academic centers and to propose a standardized handoff algorithm for the transition of care from the emergency department (ED) to an inpatient setting. METHODS: This was a cross-sectional survey targeted at the program directors, associate or assistant program directors, and faculty members of emergency medicine (EM) residency programs in the United States (U...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28115033/development-of-an-evacuation-tool-to-facilitate-disaster-preparedness-use-in-a-planned-evacuation-to-support-a-hospital-move
#12
Ranna A Rozenfeld, Sally L Reynolds, Sherri Ewing, Mary Margaret Crulcich, Michelle Stephenson
OBJECTIVES: Our institution relocated to a new facility 3.5 miles from our original location in Chicago on June 9, 2012. We describe the tools we developed to prepare, execute, and manage our evacuation and relocation. METHODS: Tools developed for the planned evacuation included the following: level of acuity and team composition classification, patient departure checklist, evacuation handoff tool, and a patient tracking system within the electronic health record...
January 24, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28106651/evaluating-the-impact-of-intraoperative-surgical-team-handoffs-on-patient-outcomes
#13
Lauren E Giugale, Sarah Sears, Erin S Lavelle, Charelle M Carter-Brooks, Michael Bonidie, Jonathan P Shepherd
OBJECTIVE: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP). METHODS: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change. Outcomes included operative (OR) time and composite variables for major complications (conversion to an open procedure, bladder injury, bowel injury, blood transfusion, infection, ileus, bowel obstruction, readmission, or mesh complication) and prolapse recurrence (prolapse at or beyond the hymen or retreatment)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#14
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28033485/acculturation-needs-of-pediatric-international-medical-graduates-a-qualitative-study
#15
Amanda D Osta, Michelle M Barnes, Regina Pessagno, Alan Schwartz, Laura E Hirshfield
: Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children. APPROACH: In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries...
December 29, 2016: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28018540/development-of-a-comprehensive-communication-skills-curriculum-for-pediatrics-residents
#16
Eleanor B Peterson, Kimberly A Boland, Kristina A Bryant, Tara F McKinley, Melissa B Porter, Katherine E Potter, Aaron W Calhoun
BACKGROUND : Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. OBJECTIVE : We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. METHODS : A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27998549/patient-hand-off-initiation-and-evaluation-phone-study-a-randomized-trial-of-patient-handoff-methods
#17
Jesse Clanton, Aimee Gardner, Michael Subichin, Patrick McAlvanah, William Hardy, Amar Shah, Joel Porter
BACKGROUND: As residency work hour restrictions have tightened, transitions of care have become more frequent. Many institutions dedicate significant time and resources to patient handoffs despite the fact that the ideal method is relatively unknown. We sought to compare the effect of a rigorous formal handoff approach to a minimized but focused handoff process on patient outcomes. METHODS: A randomized prospective trial was conducted at a large teaching hospital over ten months...
February 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/27968889/patient-safety-culture-in-surgical-departments-versus-other-departments-in-county-hospitals-of-hubei-province-china-a-cross-sectional-survey
#18
Manli Wang, Hongbing Tao, Haiqing Fang, Zhaohui Cheng, Miao Cai, Xiaojun Lin, Chang Xu
BACKGROUND: Patient safety culture affects hospital safety and performance. The Hospital Survey on Patient Safety Culture (HSOPSC) is widely used to assess the safety culture in hospital and unit level. We aimed to assess strengths and weaknesses of surgical departments compared with others in county hospitals of China with HSOPSC. METHODS: A cross-sectional study was conducted in 2015 with a Chinese translation of HSOPSC being administered to 1500 staff from 19 county hospitals in Xiaogan city of Hubei province China...
October 2016: Lancet
https://www.readbyqxmd.com/read/27965029/packaging-patients-and-handing-them-over-communication-context-and-persuasion-in-the%C3%A2-emergency-department
#19
Peter Nugus, Sally McCarthy, Anne Holdgate, Jeffrey Braithwaite, Anna Schoenmakers, Cordula Wagner
STUDY OBJECTIVE: Communication is commonly understood by health professional researchers to consist of relatively isolated exchanges of information. The social and organizational context is given limited credit. This article examines the significance of the environmental complexity of the emergency department (ED) in influencing communication strategies and makes the case for adopting a richer understanding of organizational communication. METHODS: This study draws on approximately 12 months (1,600 hours) of ethnographic observations, yielding approximately 4,500 interactions across 260 clinicians and staff in the EDs of 2 metropolitan public teaching hospitals in Sydney, Australia...
February 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27956266/what-s-ideal-a-case-study-exploring-handoff-routines-in-practice
#20
Saira N Haque, Carsten S Oesterlund, Lawrence M Fagan
BACKGROUND: Handoffs of care in the healthcare system between responsible providers have traditionally been conceptualized and studied at the point of patient transfer. Thus, clinical practice and associated information systems are designed with the concept of the handoff as a solitary event. This viewpoint does not consider the routine activities necessary for a successful handoff. We propose expanding the analysis of the handoff beyond the single point of transfer to include a routine of interrelated activities leading up to the transfer of responsibility...
December 9, 2016: Journal of Biomedical Informatics
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