9.00
Hdl Handle:
http://hdl.handle.net/10755/306577
Category:
Abstract
Type:
Poster
Title:
Smooth Sailing-Transfer of Extended Care Patient to Emergency Department
Author(s):
George, Michelle; Luchs, Brenda; Bigowsky, Mary; Pavetic, Senka
Lead Author STTI Affiliation:
Non-member
Author Details:
Michelle George, BSN, RN, CEN, michelle_george@hmis; Brenda Luchs, MSN, RN, CEN; Mary Bigowsky, MSN, RN, NEA-BC; Senka Pavetic, RN
Abstract:

Evidence-based Practice Abstract

Purpose: Improve the continuity of care between Extended Care Facility and Emergency Department by improving communication between healthcare teams.

Design: Quality improvement of transfer process using Lean Six Sigma principles.

Setting: Teaching tertiary urban non-profit hospital in Northeast Ohio, level 1 trauma center.

Participants/Subjects: Patients presenting to the emergency department from community extended care facilities.

Methods: Surveys were distributed to a sample of community extended care facilities and emergency department staff regarding continuity of care and transfer of patients to and from the emergency department. Overall surveys reflected “needs improvement” from both facilities. Initial audit of telephone transfer reports given from extended care facility to emergency department nurse revealed pertinent information present in 39% of reports. Audit identified presence of 12 criteria-(name, age, transferring physician, contact person, allergies, current vital signs, reason for transfer, code status, baseline mental status, isolation, wounds, and incontinence). Five monthly meetings were held between emergency and community extended care facility representatives at hospital. Contact information was exchanged. Goals of collaboration clearly defined-to improved transfer and continuity of care-not to find fault or assign blame in any one person or organization. Each facility verbalized process of transfer and identified areas needed for improvement with most common: anxiety (especially in time sensitive transfers), multiple tasks at once, fragmented processes, new or inexperienced staff. Using Lean Six Sigma tools- mapped process flow of emergency department and several extended care facilities, fishbone diagram to identify cause/effect to excellent and poor handoffs, PDSA (Plan Do Study Act) implementation education. Encourage each facility to use tools to identify areas for improvement within their individual processes. During the collaborative the extended care facility representatives requested education for their staff on assessment or data collection for reporting to emergency department. An education day with continuing education for extended care facility staff was held at our hospital. Thirty four nurses from community facilities attended. Emergency nurses and physicians presented information on falls, stroke, sepsis, SBAR (Situation Background Assessment Recommendations) for handoffs and case studies.

Results/Outcomes: An audit of telephone reports verified improvement. Since the collaborative 60-70% of pertinent information is included the report. The quality of reports has also improved using SBAR format by increasing amount information received.

Implications: We now have smoother transition by improving the communication between the emergency department and extended care facilities. This directly reflects on the quality of care provided to the patient. Another crucial outcome is establishing an open non threatening communication with the facilities. This will enable us to resolve any future issues and continue to improve patient care together.

Keywords:
Communication between ED and Extended Care Facilities
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Nashville, Tennessee, USA
Description:
2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleSmooth Sailing-Transfer of Extended Care Patient to Emergency Departmenten_GB
dc.contributor.authorGeorge, Michelleen_GB
dc.contributor.authorLuchs, Brendaen_GB
dc.contributor.authorBigowsky, Maryen_GB
dc.contributor.authorPavetic, Senkaen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMichelle George, BSN, RN, CEN, michelle_george@hmis; Brenda Luchs, MSN, RN, CEN; Mary Bigowsky, MSN, RN, NEA-BC; Senka Pavetic, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306577-
dc.description.abstract<p>Evidence-based Practice Abstract</p><p>Purpose: Improve the continuity of care between Extended Care Facility and Emergency Department by improving communication between healthcare teams.</p><p>Design: Quality improvement of transfer process using Lean Six Sigma principles.</p><p>Setting: Teaching tertiary urban non-profit hospital in Northeast Ohio, level 1 trauma center.</p><p>Participants/Subjects: Patients presenting to the emergency department from community extended care facilities.</p><p>Methods: Surveys were distributed to a sample of community extended care facilities and emergency department staff regarding continuity of care and transfer of patients to and from the emergency department. Overall surveys reflected “needs improvement” from both facilities. Initial audit of telephone transfer reports given from extended care facility to emergency department nurse revealed pertinent information present in 39% of reports. Audit identified presence of 12 criteria-(name, age, transferring physician, contact person, allergies, current vital signs, reason for transfer, code status, baseline mental status, isolation, wounds, and incontinence). Five monthly meetings were held between emergency and community extended care facility representatives at hospital. Contact information was exchanged. Goals of collaboration clearly defined-to improved transfer and continuity of care-not to find fault or assign blame in any one person or organization. Each facility verbalized process of transfer and identified areas needed for improvement with most common: anxiety (especially in time sensitive transfers), multiple tasks at once, fragmented processes, new or inexperienced staff. Using Lean Six Sigma tools- mapped process flow of emergency department and several extended care facilities, fishbone diagram to identify cause/effect to excellent and poor handoffs, PDSA (Plan Do Study Act) implementation education. Encourage each facility to use tools to identify areas for improvement within their individual processes. During the collaborative the extended care facility representatives requested education for their staff on assessment or data collection for reporting to emergency department. An education day with continuing education for extended care facility staff was held at our hospital. Thirty four nurses from community facilities attended. Emergency nurses and physicians presented information on falls, stroke, sepsis, SBAR (Situation Background Assessment Recommendations) for handoffs and case studies.</p><p>Results/Outcomes: An audit of telephone reports verified improvement. Since the collaborative 60-70% of pertinent information is included the report. The quality of reports has also improved using SBAR format by increasing amount information received.</p><p>Implications: We now have smoother transition by improving the communication between the emergency department and extended care facilities. This directly reflects on the quality of care provided to the patient. Another crucial outcome is establishing an open non threatening communication with the facilities. This will enable us to resolve any future issues and continue to improve patient care together.</p>en_GB
dc.subjectCommunication between ED and Extended Care Facilitiesen_GB
dc.date.available2013-12-09T17:00:06Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T17:00:06Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationNashville, Tennessee, USAen_GB
dc.description2013 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at Gaylord Resort and Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.