Rebekah Gardner1, Esther K Choo2, Stefan Gravenstein3, Rosa R Baier4. 1. Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Healthcentric Advisors, Providence, Rhode Island. 2. Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island. 3. Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Healthcentric Advisors, Providence, Rhode Island; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island; Department of Medicine-Geriatrics, Case Western Reserve University, Cleveland, Ohio. 4. Healthcentric Advisors, Providence, Rhode Island; Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island.
Abstract
BACKGROUND: Despite patients' increasing use of urgent care centers (UCC), little is known about how urgent care clinicians communicate with the emergency department (ED). OBJECTIVES: To assess ED clinicians' perceptions of the quality and consistency of communication when patients are referred from UCCs to EDs. METHODS: Emergency medicine department chairs distributed a brief, electronic survey to a statewide sample of ED clinicians via e-mail. The survey included multiple-choice and free-text questions focused on types of communication desired and received from UCCs, types of test results available on transfer, and suggestions for improvement. RESULTS: Of 199 ED clinicians, 102 (51.3%) responded. More than four out of five respondents "somewhat" or "strongly agreed" that each of the following would be helpful: a telephone call, the reason for referral, specific concern, a copy of the chart, and UCC contact information. However, ED clinicians reported not consistently receiving these: only a fifth (21.6%) of clinicians reported receiving the specific concern for their last 5 patients transferred from a UCC, and 34.3% recalled receiving a copy of the chart. Overall, 54.9% reported receiving laboratory test results "often or almost always," 49.0% electrocardiograms, and 44.1% imaging reports. Qualitative analysis revealed several themes: incomplete data when patients are referred; barriers to discussion between ED and urgent care clinicians; and possible solutions to improve communication. CONCLUSIONS: Our findings highlight variation in communication from UCCs to EDs, indicating a need to improve communication standards and practices. We identify several potential ways to improve this clinical information hand-off.
BACKGROUND: Despite patients' increasing use of urgent care centers (UCC), little is known about how urgent care clinicians communicate with the emergency department (ED). OBJECTIVES: To assess ED clinicians' perceptions of the quality and consistency of communication when patients are referred from UCCs to EDs. METHODS: Emergency medicine department chairs distributed a brief, electronic survey to a statewide sample of ED clinicians via e-mail. The survey included multiple-choice and free-text questions focused on types of communication desired and received from UCCs, types of test results available on transfer, and suggestions for improvement. RESULTS: Of 199 ED clinicians, 102 (51.3%) responded. More than four out of five respondents "somewhat" or "strongly agreed" that each of the following would be helpful: a telephone call, the reason for referral, specific concern, a copy of the chart, and UCC contact information. However, ED clinicians reported not consistently receiving these: only a fifth (21.6%) of clinicians reported receiving the specific concern for their last 5 patients transferred from a UCC, and 34.3% recalled receiving a copy of the chart. Overall, 54.9% reported receiving laboratory test results "often or almost always," 49.0% electrocardiograms, and 44.1% imaging reports. Qualitative analysis revealed several themes: incomplete data when patients are referred; barriers to discussion between ED and urgent care clinicians; and possible solutions to improve communication. CONCLUSIONS: Our findings highlight variation in communication from UCCs to EDs, indicating a need to improve communication standards and practices. We identify several potential ways to improve this clinical information hand-off.
Authors: Lorraine P Limpahan; Rosa R Baier; Stefan Gravenstein; Otto Liebmann; Rebekah L Gardner Journal: Am J Emerg Med Date: 2013-06-29 Impact factor: 2.469
Authors: Vincenza Snow; Dennis Beck; Tina Budnitz; Doriane C Miller; Jane Potter; Robert L Wears; Kevin B Weiss; Mark V Williams Journal: J Gen Intern Med Date: 2009-04-03 Impact factor: 5.128