Electronic Form Improved Patient Transfers

Abstract

CHICAGO —A standardized electronic form detailing essential patient information significantly improved communication about transfers from a skilled nursing facility to an emergency department.Physicians and staff used the electronic form for about half of 276 patient transfers from the nursing home to the Cleveland Clinic emergency department (ED) during an 8-month period, Fredric Hustey, MD, and geriatrician Robert Palmer, MD, reported at a meeting of the American Geriatrics Society.On average, when the electronic form was used, eight of the nine information elements deemed essential were communicated, said Dr. Hustey, an emergency physician at the Cleveland Clinic. Only two of the nine essential elements had been communicated, on average, per patient before the electronic form was available.The nine elements classified as essential were past medical history, medication use, allergies, advanced directives, reason for transfer, baseline mental status, baseline functional status, contact person at the nursing facility, and name of a primary care or other responsible physician.The researchers said that use of the form significantly decreased clutter in the ED from 24 pages of information transferred per patient to 5.5 pages.ED staff satisfaction with the communication process increased 11% with use of the electronic form. Satisfaction with the communication process did not change among the nursing facility staff.The satisfaction survey also identified an adversarial relationship between the two facilities' personnel, which Dr. Hustey called a common situation. CHICAGO —A standardized electronic form detailing essential patient information significantly improved communication about transfers from a skilled nursing facility to an emergency department. Physicians and staff used the electronic form for about half of 276 patient transfers from the nursing home to the Cleveland Clinic emergency department (ED) during an 8-month period, Fredric Hustey, MD, and geriatrician Robert Palmer, MD, reported at a meeting of the American Geriatrics Society. On average, when the electronic form was used, eight of the nine information elements deemed essential were communicated, said Dr. Hustey, an emergency physician at the Cleveland Clinic. Only two of the nine essential elements had been communicated, on average, per patient before the electronic form was available. The nine elements classified as essential were past medical history, medication use, allergies, advanced directives, reason for transfer, baseline mental status, baseline functional status, contact person at the nursing facility, and name of a primary care or other responsible physician. The researchers said that use of the form significantly decreased clutter in the ED from 24 pages of information transferred per patient to 5.5 pages. ED staff satisfaction with the communication process increased 11% with use of the electronic form. Satisfaction with the communication process did not change among the nursing facility staff. The satisfaction survey also identified an adversarial relationship between the two facilities' personnel, which Dr. Hustey called a common situation.