Effect of a handover tool on efficiency of care and mortality for interhospital transfers

摘要: Background Interhospital transfer is frequent, and transferred patients experience delays in the provision of care higher mortality rates when compared to directly admitted. The interhospital handover a key opportunity improve but has not been evaluated. Objective To determine effect universal tool on timeliness care, length stay (LOS), among patients. Design, setting, Retrospective cohort an academic medical center between July 1, 2009 December 31, 2010 with interrupted time-series design. Intervention One-page containing information critical for immediate patient instituted hospital-wide 2010. was completed by transferring physician available review before arrival. Measurements Time-to-admission order entry, LOS after transfer, in-hospital mortality. Results There no significant change time-to-admission entry implementation (47 minutes vs. 45 minutes, adjusted P = 0.94). nonstatistically reduction (6.5 days 5.8 days, 0.06). In-hospital declined significantly postintervention period from 12.0% 8.9% (adjusted odds ratio, 0.68; 95% confidence interval, 0.47 - 0.99, 0.04). concurrent control group. Conclusion Implementation standardized feasible may be associated reductions Widespread adoption similar tools outcomes this high-risk population. Journal Hospital Medicine 2017;12:23-28.