Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department
Abstract Objective The boarding of ICU patients in the emergency department (ED) represents a considerable risk to patient safety. This study aims to describe the generation of a rubric to ensure the fidelity of vital, written hand‐off between ED teams. Methods We performed a mixed methods design to...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13039 |
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| author | Joshua Kolikof Daniel Shaw Bryan Stenson Anne Grossestreuer Leon Sanchez David Chiu |
| author_facet | Joshua Kolikof Daniel Shaw Bryan Stenson Anne Grossestreuer Leon Sanchez David Chiu |
| author_sort | Joshua Kolikof |
| collection | DOAJ |
| description | Abstract Objective The boarding of ICU patients in the emergency department (ED) represents a considerable risk to patient safety. This study aims to describe the generation of a rubric to ensure the fidelity of vital, written hand‐off between ED teams. Methods We performed a mixed methods design to develop a scoring rubric to evaluate written hand‐off communication of medical ICU boarders between ED teams during the COVID‐19 pandemic. The primary outcome was the quality of the written hand‐off as agreed upon by the inter‐user agreement. Our secondary outcome included variability in written quality as a function of the number of separate and distinct ED teams at the point of the transition of care. Results There was a moderate inter‐user agreement with rubric scoring (κ = 0.70 [95% confidence interval, 0.66–0.75]). The overall trend noted that several key elements, including code status, performed interventions, and contingency planning, were infrequently documented. Conclusions We effectively created a quality assurance tool for ED ICU boarders that ensures relevant and vital information is relayed between ED teams. Our analysis demonstrated that all relevant information is only sometimes present in the hand‐off. |
| format | Article |
| id | doaj-art-21f450f7036f497d96954112151ff876 |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-21f450f7036f497d96954112151ff8762025-08-20T03:17:59ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-10-0145n/an/a10.1002/emp2.13039Standardized evaluation of hand‐off documentation of ICU boarders in the emergency departmentJoshua Kolikof0Daniel Shaw1Bryan Stenson2Anne Grossestreuer3Leon Sanchez4David Chiu5Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USADepartment of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USADepartment of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USADepartment of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USADepartment of Emergency Medicine Brigham and Women's Faulkner Hospital Boston Massachusetts USADepartment of Emergency Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USAAbstract Objective The boarding of ICU patients in the emergency department (ED) represents a considerable risk to patient safety. This study aims to describe the generation of a rubric to ensure the fidelity of vital, written hand‐off between ED teams. Methods We performed a mixed methods design to develop a scoring rubric to evaluate written hand‐off communication of medical ICU boarders between ED teams during the COVID‐19 pandemic. The primary outcome was the quality of the written hand‐off as agreed upon by the inter‐user agreement. Our secondary outcome included variability in written quality as a function of the number of separate and distinct ED teams at the point of the transition of care. Results There was a moderate inter‐user agreement with rubric scoring (κ = 0.70 [95% confidence interval, 0.66–0.75]). The overall trend noted that several key elements, including code status, performed interventions, and contingency planning, were infrequently documented. Conclusions We effectively created a quality assurance tool for ED ICU boarders that ensures relevant and vital information is relayed between ED teams. Our analysis demonstrated that all relevant information is only sometimes present in the hand‐off.https://doi.org/10.1002/emp2.13039health care quality assurancepatient hand offquality improvement |
| spellingShingle | Joshua Kolikof Daniel Shaw Bryan Stenson Anne Grossestreuer Leon Sanchez David Chiu Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department Journal of the American College of Emergency Physicians Open health care quality assurance patient hand off quality improvement |
| title | Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department |
| title_full | Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department |
| title_fullStr | Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department |
| title_full_unstemmed | Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department |
| title_short | Standardized evaluation of hand‐off documentation of ICU boarders in the emergency department |
| title_sort | standardized evaluation of hand off documentation of icu boarders in the emergency department |
| topic | health care quality assurance patient hand off quality improvement |
| url | https://doi.org/10.1002/emp2.13039 |
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