SHM Converge Scientific Abstract ePoster Gallery-An Electronic Medical Record Based Intervention to Improve Emergency Department to Hospital Medicine Handoffs

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This project implemented a standardized emergency department (ED) to hospital medicine (HM) handoff process using an electronic medical record (EMR) written template and secure messaging. The goal was to replace an inconsistent paging-and-phone-call system that often delayed admissions and led to miscommunication. A multidisciplinary team of ED, HM, IT, and internal medicine residents designed the template, educated staff, and evaluated the change with surveys and dashboard metrics.<br /><br />The intervention was tested at a community academic medical center, with a pre-intervention period from April 2024 to March 2025 and a post-intervention period from April 2025 to February 2026. Survey results showed strong adoption: 100% of responding ED physicians (19) and HM physicians (29) used the new process and rarely needed extra verbal clarification. Most respondents felt the handoff quality improved, communication and collaboration became more efficient, and no negative safety effects were subjectively observed.<br /><br />Operational outcomes improved after implementation. The median time from ED decision to admit to placement of admission orders decreased from 30 to 24 minutes. ED length of stay for admitted patients decreased from 302 to 216 minutes, suggesting better throughput and reduced boarding. Internal medicine resident satisfaction with handoffs improved on the ACGME survey from 66% to 77%.<br /><br />Balancing measures were mostly stable, including inpatient admissions lasting more than 24 hours (7.57% pre vs. 7.24% post). However, there was a notable increase in patients requiring transfer to a higher level of care within 12 hours of admission, raising questions about possible safety impacts or confounding factors such as higher patient volume, increased acuity, more inpatient capacity, and greater ED boarding. Overall, the EMR-based handoff improved efficiency and communication, with further study needed to assess safety.

Asset Subtitle

Kristin Lohr

Meta Tag

Author List Benjamin Bui, Colleen O'Connor, Henry Burke, Jonathan Doroshow, Kristin Lohr, Patrick Zeniecki

Category Research

Concept Emergency Department to Hospital Medicine Handoff

Concept Standardized Template

Concept Admission Order Placement

Concept Emergency Department Length of Stay

Concept Shared Electronic Medical Record Results Pool

Distinguished Non-Finalist

Presenter Organization Main Line Health - Lankenau Medical Center

Presenting Author Kristin Lohr

Track Transitions of Care

Keywords

emergency department

hospital medicine

handoff process

electronic medical record

secure messaging

admission efficiency

patient throughput

length of stay

communication improvement

clinical workflow

Emergency Department to Hospital Medicine Handoff

Standardized Template

Admission Order Placement

Emergency Department Length of Stay

Shared Electronic Medical Record Results Pool