We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record

Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant R; Wu, Ethel

doi:10.1002/jhm.2336

Cited by 35 publications

(48 citation statements)

References 18 publications

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“…Involving the patient in the decision to temporarily increase their opioid dose may improve patient‐perceived pain control . In addition, when possible, close communication between the hospitalist and the primary care physician may alleviate some of the uncertainty hospitalists feel when they prescribe an increased dose of chronic opioid therapy …”

Section: Discussionmentioning

confidence: 99%

“…38 In addition, when possible, close communication between the hospitalist and the primary care physician may alleviate some of the uncertainty hospitalists feel when they prescribe an increased dose of chronic opioid therapy. 39,40 Opioid prescribing practices by hospitalists were influenced by past negative experiences. This principle, defined as negativity bias, refers to the notion that in most situations, negative events are more salient, potent, and dominant than positive events.…”

Section: Discussionmentioning

confidence: 99%

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The hospitalist perspective on opioid prescribing: A qualitative analysis

Calcaterra

Drabkin

Leslie

et al. 2016

Journal of Hospital Medicine

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Background Pain is a frequent symptom among patients in the hospital. Pain management is a key quality indicator for hospitals and hospitalists are encouraged to frequently assess and treat pain. Optimal opioid prescribing, described as safe, patient-centered and informed opioid prescribing, may be at odds with the priorities of current hospital care, which focuses on patient-reported pain control rather than the potential long-term consequences of opioid use. Objective We aimed to understand physicians’ attitudes, beliefs and practices towards opioid prescribing during hospitalization and discharge. Design In-depth, semi-structured interviews Setting Two university hospitals, a safety-net hospital, a Veterans Affairs hospital, and a private hospital located in Denver, Colorado or Charleston, South Carolina. Participants Hospitalists (N=25) Measurements We systematically analyzed transcribed interviews and identified emerging themes using a team-based mixed inductive and deductive approach. Results Although hospitalists felt confident in their ability to control acute pain using opioid medications, they perceived limited success and satisfaction when managing acute exacerbations of chronic pain with opioids. Hospitalists recounted negative sentinel events which altered opioid prescribing practices in both the hospital setting and at the time of hospital discharge. Hospitalists described prescribing opioids as a pragmatic tool to facilitate hospital discharges or prevent readmissions. At times, this left them feeling conflicted about how this practice could impact the patient over the long term. Conclusions Strategies to provide adequate pain relief to hospitalized patients, which allow hospitalists to safely and optimally prescribe opioids while maintaining current standards of efficiency, are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The hospitalist perspective on opioid prescribing: A qualitative analysis

Calcaterra

Drabkin

Leslie

et al. 2016

Journal of Hospital Medicine

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“…A recent survey of PCPs by Sheu et al indicated that for many discharges, information in addition to that present in the EHR was desirable to ensure a safe transition of care. 6 Two-way communication, such as with a phone call, allows for senders to verify information receipt and for receivers to ask questions to ensure complete information. To our knowledge, there have been no previous reports describing processes for improving verbal communication between hospitalist services and PCPs at discharge.…”

Section: Discussionmentioning

confidence: 99%

Improving the reliability of verbal communication between primary care physicians and pediatric hospitalists at hospital discharge

Mussman

Vossmeyer

Brady

et al. 2015

Journal of Hospital Medicine

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INTRODUCTION Timely and reliable verbal communication between hospitalists and primary care physicians (PCPs) is critical for prevention of medical adverse events but difficult in practice. Our aim was to increase the proportion of completed verbal handoffs from on‐call residents or attendings to PCPs within 24 hours of patient discharge from a hospital medicine service to ≥90% within 18 months. METHODS A multidisciplinary team collaborated to redesign the process by which PCPs were contacted following patient discharge. Interventions focused on the key drivers of obtaining stakeholder buy‐in, standardization of the communication process, including assigning primary responsibility for discharge communication to a single resident on each team and batching calls during times of maximum resident availability, reliable automated process initiation through leveraging the electronic health record (EHR), and transparency of data. A run chart assessed the impact of interventions over time. RESULTS The percentage of calls initiated within 24 hours of discharge improved from 52% to 97%, and the percentage of calls completed improved to 93%. Results were sustained for 18 months. Standardization of the communication process through hospital telephone operators, use of the discharge order to ensure initiation of discharge communication, and batching of phone calls were associated with improvements in our measures. CONCLUSION Reliable verbal discharge communication can be achieved through the use of a standardized discharge communication process coupled with the EHR. Journal of Hospital Medicine 2015;10:574–580. © 2015 Society of Hospital Medicine

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“…The use of telehealth was also regarded as a facilitator of actual nursing and as a barrier factor causing fear of changes in work. Both these subcategories were based on findings from the same studies (5,10,11,14,15,19). The nursing staff felt that the use of telehealth increases their job satisfaction (1), decreases the workload (5,12) and reduces stress (14,19).…”

Section: Synthesised Findingsmentioning

confidence: 99%

Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies

Koivunen

Saranto

2017

Scandinavian Caring Sciences

146

148

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The aim of the study was to synthesise the best available research evidence on nursing professionals' experiences of the facilitators and barriers to the use of online telehealth services in nursing practice. Telehealth is used to deliver healthcare services and health-related information by means of information and communication technology (ICT). The systematic review of qualitative studies was conducted using thematic synthesis of previous studies. International electronic databases PubMed, CINAHL, Eric, Web of Science/Web of Knowledge and Scopus, and Finnish databases Medic and Ohtanen were searched in spring 2013. In addition, the search was complemented in fall 2015. Following critical appraisal, 25 studies from 1998 to fall 2015 were reviewed and the findings were synthesised. Both facilitators and barriers were grouped into five main categories which were related to nurses' skills and attitudes, nurses' work and operations, organisational factors, patients and technology. The highest number of facilitators and barriers was found in the category focusing on nurses' work and operations. Based on the findings, nurses' skills and attitudes are preventing factors in the implementation of telehealth. There is also a need to focus on patients' role in telehealth usage although the findings support positive adoption of ICT tools among patients. The findings call for further development of technological tools used in nursing practice and healthcare services. The change from traditional face-to-face nursing to the use of telehealth calls for local agreements and further discussions among professionals on how this change will be accepted and implemented into practice. In addition, organisations need to make sure that nurses have enough resources and support for telehealth use.

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We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record

Cited by 35 publications

References 18 publications

The hospitalist perspective on opioid prescribing: A qualitative analysis

The hospitalist perspective on opioid prescribing: A qualitative analysis

Improving the reliability of verbal communication between primary care physicians and pediatric hospitalists at hospital discharge

Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies

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