- 作者：Rebekah Gardner ; MD&lowast ; ; &dagger ; ; ; Esther K. Choo ; MD ; MPH&Dagger ; ; § ; ; Stefan Gravenstein ; MD ; MPH&lowast ; ; &dagger ; ; § ; ; ‖ ; Rosa R. Baier ; MPH&dagger ; ; § ;
- 关键词：urgent care centers ; communication ; care transitions ; hand-offs ; quality improvement
- 刊名：Journal of Emergency Medicine
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：50
- 期：3
- 页码：416-421
- 全文大小：244 K
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.