Evaluation of an asynchronous physician voicemail sign-out for emergency department admissions.

摘要: Study objective Communication failures contribute to errors in the transfer of patients from emergency department (ED) inpatient medicine units. Oral (synchronous) communication has numerous benefits but is costly and time consuming. Taped (asynchronous) may be more reliable efficient lacks interaction. We evaluate a new asynchronous physician-physician sign-out compared with traditional synchronous sign-out. Methods A voicemail-based, semistructured for routine ED admissions internal was implemented October 2007 at an urban, academic medical center. Outcomes were obtained by pre- postintervention surveys house staff, physician assistants, hospitalist attending physicians examination access logs administrative data. Outcome measures included utilization; perceptions ease, accuracy, content, interaction, errors; rate transfers ICU floor within 24 hours admission. Results analyzed both quantitatively qualitatively standard qualitative analytic techniques. During September 2008 (1 year postintervention), voicemails recorded about 90.3% admissions; 69.7% these accessed least once admitting physicians. The median length each 2.6 minutes (interquartile range 1.9 3.5). received 117 197 responses (59%) preintervention survey 113 206 (55%) survey. total 73 101 (72%) respondents reported dictated easier than oral 43 (43%) it accurate. However, 70 (69%) that interaction among participants worse. There no change admission April June (65/6,147; 1.1%) versus (70/6,263; 1.1%); difference 0%, 95% confidence interval –0.4% 0.3%. proportion internists reporting 1 perceived adverse event relating decreased nonsignificant 10% after intervention (95% –27% 6%), 44% (32/72) 34% (23/67). Conclusion Voicemail ED–internal without any early or perception major events. reduced. means improving stable admissions.