Assessing written communication during interhospital transfers of emergency general surgery patients

Felicity N.R. Harl, Megan C. Saucke, Caprice C. Greenberg, Angela M. Ingraham

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. Methods We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016. Elements of written communication were abstracted from referring facility documents scanned into the medical record using a standardized abstraction protocol. Descriptive statistics summarized the information communicated. Results A total of 129 patients met inclusion criteria. 87.6% (n = 113) of charts contained referring hospital documents. 42.5% (n = 48) were missing history and physicals. Diagnoses were missing in 9.7% (n = 11). Ninety-one computed tomography scans were performed; among 70 with reads, final reads were absent for 70.0% (n = 49). 45 ultrasounds and x-rays were performed; among 27 with reads, final reads were missing for 80.0% (n = 36). Reasons for transfer were missing in 18.6% (n = 21). Referring hospital physicians outside the ED were consulted in 32.7% (n = 37); consultants’ notes were absent in 89.2% (n = 33). In 12.4% (n = 14), referring documents arrived after the patient's ED arrival and were not part of the original documentation provided. Conclusions This study documents that information important to patient care is often missing in the written communication provided during interhospital transfers. This gap affords a foundation for standardizing provider communication during interhospital transfers.

Original languageEnglish (US)
Pages (from-to)86-92
Number of pages7
JournalJournal of Surgical Research
Volume214
DOIs
StatePublished - Jun 15 2017
Externally publishedYes

Keywords

  • Communication
  • Emergency general surgery
  • Interhospital transfers

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Assessing written communication during interhospital transfers of emergency general surgery patients'. Together they form a unique fingerprint.

Cite this