QIT Intervention Improving Health Communication During Facility Transfer

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Primary Author:</td>
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Angela Baxter, RN, BSN</td>
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Co-Principal Investigators/Collaborators:</td>
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<p align="left">Dr. Bharata Lankachandra, Jennifer Miller, PharmD, BCPS, Lori Birkeness, RN, BSN, Linda Bailey, LMSW</p>
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Organization:</td>
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Kansas City VA Medical Center</td>
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Abstract</h2>
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Purpose</h3>
<p>To evaluate a standardized communication approach aimed at improving health communication for veterans being discharged from the Kansas City VA Medical Center (KCVA) acute care facility to a Skilled Nursing Facility (SNF) or other tertiary care facility.</p>
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Background</h3>
<p>As standard QA for Contract Nursing Home patients, a retrospective chart review and comparison of 149 veteran patients being transferred from the acute setting to a SNF was conducted. Data from a 7 month period revealed communication discrepancies occurred 28.9% of the time. The discrepancies varied, from the failure to receive medication orders to incorrect medications and transcription errors. </p>
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Materials & Methods</h3>
<p align="left">Members of the QIT Interdisciplinary Team (IDT), which included a Hospitalist, PharmD, Transition Social Worker, and Transition RN’s reviewed current policy and procedure and identified areas of concern. The IDT team developed a “Nursing Home Transfer Orders” electronic communication tool. The tool identified necessary data which would improve health-related communication. Thus, the pharmacist developed a medication reconciliation report and a discharge medication list, the nurses provide input to Residents and Staff Physician completing “Nursing Home Transfer Orders” note. The social worker altered present policy to include faxing the “Nursing Home Transfer Orders” and medical information as well as having this information accompany the veteran. After training was provided to potential users of this tool, it was implemented uniformly throughout the KCVA acute care facility.</p>
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Results</h3>
<p>Subsequent retrospective chart review revealed a decrease in communication discrepancies to 20%. Analyses of the discrepancies indicate that the majority of these were transcription errors, an event not under the control of acute care professionals.</p>
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Conclusion</h3>
<p>The “Nursing Home Transfer Order” communication guide standardized the content and format of healthcare orders for veterans being transferred from the acute care KCVA to a SNF or other tertiary care facility. Implementation of this guide reduced communication errors by almost 10%. </p>
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Bibliography</h3>
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None</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>