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Development and Testing of Emergency Department Patient Transfer Communication Measures

Authors

  • Jill Klingner RN, PhD,

    1. Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
    2. Labovitz School of Business and Economics, University of Minnesota Duluth, Duluth, Minnesota
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  • Ira Moscovice PhD

    1. Rural Health Research Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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  • This work was supported by: (1) The Centers for Medicare & Medicaid Services (CMS), an agency of the US Department of Health and Human Services (DHHS), Contract No. 500-02-MN01, government task leader Edwin Huff, PhD, CMS Boston Regional Office. This study does not necessarily reflect CMS policies. It was also funded through the “7th Scope of Work” for the Quality Improvement Organization (QIO) for Minnesota, which is StratisHealth (7SOW-MN-1C-05-15); and (2) the federal Office of Rural Health Policy, Health Resources and Services Administration, DHHS (PHS GRANT NO. U27RH01080). The authors would like to acknowledge the contributions of the 68 hospital participants; Stratis Health, Stroudwater Associates, Performance Management Institute, Washington Rural Health Quality Network; and the 3 expert panels without whom this work would not have been possible. For further information, contact Jill M. Klingner, RN, PhD, Labovitz School of Business and Economics, 1318 Kirby Drive 335 K LSBE, University of Minnesota Duluth, Duluth, MN 55812; e-mail klin0089@d.umn.edu.

Abstract

Purpose: Communication problems are a major contributing factor to adverse events in hospitals.1 The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication.

Methods: Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement.

Findings: It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities.

Conclusion: Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013.

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