SHM Converge Scientific Abstract ePoster Gallery-Flash in Pan or Sustained Success: Assessing Sustainability of a Standardized Interhospital Transfer Note and Process

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This study examined whether use of a standardized templated interhospital transfer note (Tnote) persisted after implementation across Department of Medicine specialties at Thomas Jefferson University Hospital. Prior work showed the Tnote improved patient safety and physician satisfaction, with lower mortality and possible reductions in rapid responses and code events.<br /><br />Researchers reviewed interhospital transfer patients in two time periods: a “close” year immediately after rollout (3/1/2022–2/28/2023) and a “distant” year one year later (3/1/2023–2/29/2024). They combined automated data export with manual chart verification, focusing only on Tnote use. Manual verification was performed in a subset to test whether automated detection of Tnotes was accurate.<br /><br />In the close period, 457 of 2,008 transfers (23%) had a Tnote documented before admission. Usage varied widely by specialty: Cardiology 13%, Gastroenterology/Hepatology 6.1%, Pulmonary/Critical Care 11%, and Hospital Medicine 65%. In the distant period, overall Tnote use increased to 817 of 2,313 transfers (35%). Specialty trends also changed: Cardiology fell to 8.4%, Gastroenterology/Hepatology rose to 25%, Pulmonary/Critical Care rose to 34%, and Hospital Medicine remained high at 66%.<br /><br />Automated export correctly identified 427 of 471 Tnotes (91%) during manual verification, suggesting the data extraction method was reliable.<br /><br />Overall, adherence to the standardized transfer note remained below the 100% target one year later, with improvement in some subspecialties but decline in Cardiology. The authors suggest that repeated education, stronger leadership engagement, and clinical decision support may help sustain adherence and improve outcomes.

Asset Subtitle

Coby Felts

Meta Tag

Author List Alan A. Kubey, Coby Felts, David Bemis, Kennedy Gallagher

Category Research

Concept Interhospital Transfer Process

Concept Templated Note

Concept Standardized Transfer Note

Concept Patient Safety

Concept Adoption Rate

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Coby Felts

Track Quality Improvement

Keywords

interhospital transfer note

Tnote

Department of Medicine

Thomas Jefferson University Hospital

patient safety

physician satisfaction

specialty adherence

manual chart verification

automated data export

clinical decision support

Interhospital Transfer Process

Templated Note

Standardized Transfer Note

Patient Safety

Adoption Rate