Abstract
BackgroundAccurate and timely patient handovers from hospital to other health care settings are essential in order to provide high quality of care and to ensure patient safety. We aim to investigate the effect of a comprehensive discharge bundle, the Transfer Intervention Procedure (TIP), on the time between discharge and the time when the medical, medication and nursing handovers are sent to the next health care provider. Our goal is to reduce this time to 24 h after hospital discharge. Secondary outcomes are length of hospital stay and unplanned readmission within 30 days rates.MethodsThe current study is set to implement the TIP, a structured discharge process for all patients admitted to the hospital, with the purpose to provide a safe, reliable and accurate discharge process. Eight hospitals in the Netherlands will implement the TIP on one internal medicine and one surgical ward. An interrupted time series (ITS) analysis, with pre-defined pre and post intervention periods, will be conducted. Patients over the age of 18 admitted for more than 48 h to the participating wards are eligible for inclusion. At least 1000 patients will be included in both the pre-implementation and post-implementation group. The primary outcome is the number of medical, medication and nursing handovers being sent within 24 h after discharge. Secondary outcomes are length of hospital stay and unplanned readmission within 30 days. With regard to potential confounders, data will be collected on patient’s characteristics and information regarding the hospitalization. We will use segmented regression methods for analyzing the data, which allows assessing how much TIP changed the outcomes of interest immediately and over time.DiscussionThis study protocol describes the implementation of TIP, which provides the foundation for a safe, reliable and accurate discharge process. If effective, nationwide implementation of the discharge bundle may result from this study protocol.Trial RegistrationDutch Trial Registry: NTR5951
Highlights
Accurate and timely patient handovers from hospital to other health care settings are essential in order to provide high quality of care and to ensure patient safety
We aim to investigate the effect of a Transfer Intervention Procedure (TIP) on the time between hospital discharge and the time when the medical, medication and nursing handovers are being sent to the health care provider
Our goal is to reduce this time to 24 h after hospital discharge for all patient handovers
Summary
Accurate and timely patient handovers from hospital to other health care settings are essential in order to provide high quality of care and to ensure patient safety. Secondary outcomes are length of hospital stay and unplanned readmission within 30 days rates. Proper patient handovers from hospital to other health care providers are essential in order to provide high quality of care and to ensure patient safety. Delays or errors in patient handovers can have serious consequences, including adverse drug events and readmissions within 30-days post-discharge [7]. Hospital stays are becoming shorter and an increasing numbers of older patients and chronically ill patients with chronic diseases and/or comorbidity require coordinated and continuous care [8]
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