Jennifer L Rosenthal1, Patrick S Romano2,3,4, Jolene Kokroko5, Wendi Gu5, Megumi J Okumura6. 1. Departments of Pediatrics and rosenthal@ucdavis.edu. 2. Departments of Pediatrics and. 3. Internal Medicine, and. 4. Center for Healthcare Policy and Research, University of California, Davis, Sacramento, California; and. 5. School of Medicine and. 6. Department of Pediatrics and Internal Medicine, University of California, San Francisco, San Francisco, California.
Abstract
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care. METHODS: We performed an exploratory prospective cohort study on communication practices and patient outcomes during interfacility transfers to general pediatric floors. Data were collected from provider surveys and chart review. Descriptive statistics were used to summarize survey responses. Logistic regression was used to analyze the association of communication deficits with odds of having a perceived error in care. RESULTS: A total of 633 patient transfers were reviewed; 218 transport command physician surveys and 217 frontline provider surveys were completed. Transport command physicians reported higher proportions of key elements being included in the verbal handoff compared with frontline providers. The written key element transmitted with the lowest frequency was a summary document (65.2%), and 13% of transfers had at least 1 perceived error in care. Transfers with many deficits were associated with higher odds of having a perceived error in care. CONCLUSIONS: Information transmission during pediatric transfers is perceived to be inconsistently complete. Deficits in the verbal and written information transmission are associated with odds of having a perceived error in care.
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care. METHODS: We performed an exploratory prospective cohort study on communication practices and patient outcomes during interfacility transfers to general pediatric floors. Data were collected from provider surveys and chart review. Descriptive statistics were used to summarize survey responses. Logistic regression was used to analyze the association of communication deficits with odds of having a perceived error in care. RESULTS: A total of 633 patient transfers were reviewed; 218 transport command physician surveys and 217 frontline provider surveys were completed. Transport command physicians reported higher proportions of key elements being included in the verbal handoff compared with frontline providers. The written key element transmitted with the lowest frequency was a summary document (65.2%), and 13% of transfers had at least 1 perceived error in care. Transfers with many deficits were associated with higher odds of having a perceived error in care. CONCLUSIONS: Information transmission during pediatric transfers is perceived to be inconsistently complete. Deficits in the verbal and written information transmission are associated with odds of having a perceived error in care.
Authors: Monica K Lieng; Heather M Siefkes; Jennifer L Rosenthal; Hadley S Sauers-Ford; Jamie L Mouzoon; Ilana S Sigal; Parul Dayal; Shelby T Chen; Cheryl L McBeth; Sandie Dial; Genevieve Dizon; Haley E Dannewitz; Kiersten Kozycz; Torryn L Jennings-Hill; Jennifer M Martinson; Julia K Huerta; Emily A Pons; Nicole Vance; Breanna N Warnock; James P Marcin Journal: Pediatr Crit Care Med Date: 2019-09 Impact factor: 3.624
Authors: Jennifer L Rosenthal; Hadley S Sauers-Ford; Michelle Y Hamline; JoAnne E Natale; James P Marcin; Su-Ting T Li Journal: Hosp Pediatr Date: 2020-06-08