Increasing PCP and Hospital Medicine Physician Verbal Communication During Hospital Admissions

Zackoff, Matthew; Graham, Camille; Warrick, Denise; Pulda, Kathleen; Gosdin, Craig; Simpson, Blair; Marischen, Jessica; Bunch, Paul M.; Vossmeyer, Michael T.; Mussman, Grant M.

doi:10.1542/hpeds.2017-0119

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…They are only possible if contact is established before discharge. In our study, as for Zackhof et al, contacts made before discharge allow better level of collaboration [22].…”

Section: Which Patients To Focus On?supporting

confidence: 64%

“…Such communication gives the information provider the status of "expert and holder of the truth". A two-way information exchange would improve collaboration [26], by giving PCPs the opportunity to ask questions, exchange information and collaboratively plan follow-up [1,22]. As in our study, Pantilat et al reported that treating physicians preferred the use of the telephone [8].…”

Section: Limitationsmentioning

confidence: 53%

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Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits

Enzinger

Dumanoir

Boussat

et al. 2021

Preprint

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Background The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge. Methods This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 hours prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians' opinions on the benefits of this contact and its effect on readmission rates. Results 275 patients were eligible. 8 hospitalists and 130 PCPs gave their opinion. Calls attempts were made for 71% of eligible patients. Call attempts resulted in successful contact with the PCP 157 times, representing 80% of call attempts and 57% of eligible patients. The average success rate for calls was 47%. The telephone contact was perceived by hospitalist as useful and providing security. The PCPs were satisfied and wanted this intervention to become systematic. Telephone contact did not reduce the readmission rate. Conclusions Despite the implementation of a standardized process, the feasibility of the intervention was modest. The main obstacle was hospitalists lacking time and facing difficulties in reaching the PCPs. However, physicians showed desire to communicate directly by telephone at the time of discharge. Trial registration French C.N.I.L. registration number 2108852. Registration date October 12, 2017.

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“…They are only possible if contact is established before discharge. In our study, as for Zackhof et al, contacts made before discharge allow better level of collaboration [22].…”

Section: Which Patients To Focus On?supporting

confidence: 64%

Section: Limitationsmentioning

confidence: 53%

Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits

Enzinger

Dumanoir

Boussat

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…[23][24][25][26][27] Methods of assessment varied from use of trained observers or scorers to surveys of individuals and colleagues about performance. Though a few leveraged informatics, 22,27 all approaches relied on human interaction, and none were automated.…”

Section: Safementioning

confidence: 99%

“…9 Methods of assessment varied widely across studies and included observations in the clinical environment, 28,30,31 performance in simulations, 32 and surveys about performance. [22][23][24][25][26] A handful of approaches were more automated and made use of informatics 8,9,22 or data collected for other health system purposes. 8,9 Effective Effectiveness was most often assessed through adherence to consensus and evidence-based guidelines.…”

Section: Timelymentioning

confidence: 99%

“…Sign-out for cross-covering providers Survey of cross-covering provider on sign-out adequacy for patient inquiries 15 Iterative scoring of sign-outs on 13 desired elements 16 Handoffs to new primary provider 18-item survey of new primary provider within 48 hours of assuming care 17 Discharge summaries Scoring via a 13-element checklist 18 Scoring for required and recommended elements, as well as readability [19][20][21] Scoring heart failure patients on 29 elements important for heart failure care 23 PCP awareness of hospitalization Single-question survey faxed to PCP at 2 weeks after discharge 24,25 Interrogation of phone records for a call to PCP's office during hospitalization 22 Resolution of discharge barriers 12-item checklist of barriers completed daily by patients 28 Medication changes across transitions of care Comparison of EHR medication list at admission and discharge with medication list 3 days after discharge per phone call with patient 27 Adverse events after discharge Structured phone interview with patient 2 weeks after discharge 24 Reasons for SNF readmission Interviews with SNF clinicians about specific readmitted patients 26 Unprofessional behavior 35-item survey of self and peers that included behaviors that may hinder safety 53 Timely (n =11) Time spent on various activities Observation by trained observers of work process 30,31 Admission ID of care goals Coded admission encounters in seriously ill patients 29 Evidence/guideline application Evaluation of performance in simulated cases: COPD and sepsis 32 PCP awareness of hospitalization Single-question survey faxed to PCP at 2 weeks after discharge 24,25 Interrogation of phone records for a call to PCP's office during hospitalization 22 Discharge summaries Verification of completion relative to date of discharge and determination of whether it was sent to outside practitioner 18 Reasons for SNF readmission Interviews with SNF clinicians about specific readmitted patients 26 Multidimensional dashboard of individual/group performance Collation of system metrics such as early discharge orders, 9 length of stay, 8,9 timing of follow-up 8…”

Section: Safe (N =15) Interhospital Communication Scoring Of Recordedmentioning

confidence: 99%

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A STEEEP Hill to Climb: A Scoping Review of Assessments of Individual Hospitalist Performance

Dow¹,

Chopski²,

Cyrus³

et al. 2020

Journal of Hospital Medicine

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BACKGROUND: Although ensuring high-quality care requires assessment of individual hospitalist performance, current assessment approaches lack consistency and coherence. The Institute of Medicine’s STEEEP framework for quality healthcare conceptualizes quality through domains of “Safe,” “Timely,” “Effective,” “Efficient,” “Equitable,” and “Patient Centered.” This framework may be applicable to assessing individual hospitalists. OBJECTIVE: This scoping review sought to identify studies that describe variation in individual hospitalist performance and to code this data to the domains of the STEEEP framework. METHODS: Via a systematic search of peer-reviewed literature that assessed the performance of individual hospitalists in the Medline database, we identified studies that described measurement of individual hospitalist performance. Forty-two studies were included in the final review and coded into one or more domains of the STEEEP framework. RESULTS: Studies in the Safe domain focused on transitions of care, both at discharge and within the hospital. Many studies were coded to more than one domain, especially Timely, Effective, and Efficient. Examples include adherence to evidence-based guidelines or Choosing Wisely recommendations. The Patient Centered domain was most frequently coded, but approaches were heterogeneous. No included studies addressed the domain Equitable. CONCLUSIONS: Applying the STEEEP framework to the published literature on assessment of individual hospitalist performance revealed strengths and weaknesses. Areas of strength were assessments of transitions of care and application of consensus guidelines. Other areas, such as equity and some components of safe practice, need development. All domains would benefit from more practical approaches. These findings should stimulate future work on feasibility of multidimensional assessment approaches.

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Implementation and Evaluation of an Artificial Intelligence Driven Simulation to Improve Resident Communication With Primary Care Providers

Merritt

Glisson

Dewan

et al. 2022

Academic Pediatrics

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Increasing PCP and Hospital Medicine Physician Verbal Communication During Hospital Admissions

Cited by 8 publications

References 16 publications

Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits

Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits

A STEEEP Hill to Climb: A Scoping Review of Assessments of Individual Hospitalist Performance

Implementation and Evaluation of an Artificial Intelligence Driven Simulation to Improve Resident Communication With Primary Care Providers

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