SHM Converge Scientific Abstract ePoster Gallery-Documenting Outside Hospital Transfer Communications to Improve Transitions of Care

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This pilot study evaluated a standardized outside-hospital (OSH) transfer communication process and templated note at a single academic medical center, expanding a previously successful hospital medicine workflow to all Department of Medicine specialties.<br /><br />The intervention began with an email from the department chair in February 2022 explaining the rationale and instructions for using the standardized process. Because email engagement appeared limited, leaders later gave face-to-face education to division directors and then individual divisions: gastroenterology, pulmonology, and cardiology. Researchers reviewed 1,037 OSH transfers from April to October 2022 using chart review and automated data export.<br /><br />Overall, 39.8% of transfer events included an OSH note. Utilization was already high in hospital medicine, ranging from 87.76% to 97.62% monthly. After direct division communication, utilization increased notably in pulmonology from 12.78% to 50.00% and rose in gastroenterology from 14.12% to 21.59% (not statistically significant). Cardiology, which received education after the study period, showed early utilization between 14.89% and 46.67%.<br /><br />Clinical outcomes were better when any OSH note was present. Patients with a transfer note had lower 24-hour mortality (0.00% vs 1.12%, p=0.0310) and lower 30-day mortality (4.60% vs 8.97%, p=0.0078). There were no significant differences in 24-hour code events or ICU transfers. Templated notes did not differ significantly from non-templated notes in these outcomes, though there was a trend toward fewer codes within 24 hours in the templated group.<br /><br />The study concludes that structured transfer documentation may improve patient safety, and that face-to-face communication is more effective than email for increasing adoption of the process.

Asset Subtitle

Kennedy Gallagher

Meta Tag

Author List Alan A. Kubey, Jeffrey Riggio, Kennedy Gallagher

Category Research

Concept Patient Safety

Concept Patient Transfer

Concept Patient Transfer Note

Concept Hospital Transfer Communication

Concept Transfer Communication Documentation

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Kennedy Gallagher

Track Quality Improvement

Keywords

outside-hospital transfer

standardized communication

templated note

Department of Medicine

patient safety

transfer documentation

hospital medicine workflow

utilization rates

mortality outcomes

face-to-face education

Patient Safety

Patient Transfer

Patient Transfer Note

Hospital Transfer Communication

Transfer Communication Documentation