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Abstract Details

A Delicate Handoff: Improving Transfer of Care from the Neurologic Intensive Care Unit (ICU) to Non-ICU Neurologic Hospital Services
Neurologic 好色先生
P05 - (-)
009
BACKGROUND: Transfer of neurologic patients from an ICU to hospital services is a complex process leading to discontinuity in care with potential for errors.
DESIGN/METHODS: A survey methodology was used to identify problem areas in the Neurosciences ICU to non-ICU transfer process. A standardized documentation template was developed with sections addressing medication reconciliation, urinary catheter use, vital sign parameters, rehabilitation consultation and outstanding test results. Physicians during the three-month intervention period were trained to incorporate elements of the template into the transfer note. Physician satisfaction regarding the transfer process was assessed before and after intervention.
RESULTS: The survey response rate was 37.5% pre-intervention and 19% post-intervention. The compliance rate of the standardized transfer template was 93%. Overall, satisfaction with the transfer process by accepting physicians was unchanged in the post-intervention period (p=0.34). There was a significant decline in the average number of patient transfers with urinary catheter (1.74 to 0.79; p=0.04), but not in the number of times that medications had not been reconciled (1.84 to 1.26; p=0.20). The majority of accepting physicians felt that the transfer template made documentation easier to complete (74%) and saved time for the physician in the transfer process (95%). Of accepting physicians, 84% felt that the template should continue, with the most useful aspects being medication reconciliation and reducing urinary catheter use. Of transferring physicians, 88% felt that the template reminded them to address an issue prior to patient transfer.
CONCLUSIONS: The implementation of standardized documentation for the transfer of neurologic patients from the ICU to the non-ICU hospital services was beneficial to both transferring and accepting physicians, and decreased the number of patients transferred with urinary catheters, potentially preventing infections.
Authors/Disclosures
Neha M. Kramer, MD (Rush University Medical Center)
PRESENTER 		Dr. Kramer has nothing to disclose.
Elizabeth A. Coon, MD, FAAN (Mayo Clinic) Dr. Coon has received publishing royalties from a publication relating to health care. Dr. Coon has a non-compensated relationship as a Non-Voting Member of the Board of Directors with UCNS that is relevant to AAN interests or activities.
Rachel R. Fabris, MD (Spectrum Health Medical Group) No disclosure on file
James P. Klaas, MD, FAAN An immediate family member of Dr. Klaas has received publishing royalties from a publication relating to health care.
Kelly D. Foote, MD Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.
David B. Burkholder, MD, FAAN (Mayo Clinic) The institution of Dr. Burkholder has received research support from Longboard pharmaceuticals.
Eileen Broomall, MD Dr. Broomall has nothing to disclose.
Jonathan Graff-Radford, MD, FAAN Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Open evidence . The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as a Faculty Member with IMPACT AD .
Samuel A. Moore, MD No disclosure on file
Hokuto Morita, MD (University of North Carolina at Chapel Hill) No disclosure on file
Mark N. Rubin, MD (Edward Hines, Jr. VAMC) Dr. Rubin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NovaSignal. Dr. Rubin has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for INSPE.
Jeffrey W. Britton, MD, FAAN (Mayo Graduate School of Medicine) Dr. Britton has received personal compensation in the range of $0-$499 for serving as a Online course with American Clinical Neurophysiology Society.