There’s a seven hour event tomorrow (8-3, ET) that will be live, webcast, tweeted and discussed on Google+. It’s about information transfer during transitions of care. It’s important. Here’s why.
Read Brian Ahier’s post about it on Government Health IT.
Register here.
Anyone with half a brain knows that the right information makes it easier to do the job right. Unfortunately, to a large extent health providers haven’t done anything about getting information into other people’s hands. And harm can result.
Case in point: on July 14 my mom had a total hip replacement in Maryland. My two super-sisters were all over the case, and everything went well. But her discharge to rehab failed. Why? Because those two facilities don’t have HIE: Health Information Exchange. So the rehab place had to transcribe Mom’s information. Manually. As in, retype everything.
As in, typos.
As in, hyperthyroid got mixed up with hypothyroid.
And if super-sister Amy hadn’t been checking everything, that could have done her real harm. She could have become another statistic, a medical error, filed under These Things Happen.
This is Care Transition – when you (or your mother, or child, or…) is passed from one provider to another. The best intentioned clinician can’t possibly perform to the best of their ability if they’re not given the information.
So care transitions are part of what America’s government is working on, as part of the push to adopt health IT. Tomorrow’s event should provide comprehensive information about many aspects of the issue. I can’t be there – I’m speaking at a conference in Buffalo – but you can! And I’ll follow up with the archives later.
Care transitions are important. Without reliable information transition, the care transition can become dangerous. Good IT can help.
Yeah….sadly too common. Dealing the same issue for myself. One large facility none of the systems can speak to each other. Healthcare clinic within hosp cannot get data from hospital, Ortho office in hospital cannot share or get info from healthcare clinic or hosp. And surgery center owned by ortho clinic cannot get data from ortho’s office, hospital, or healthcare clinic…It’s a unmerry-go-round.
Alex, you are SO right! This is way too common and your story adds to the urgency of the situation. Aside from the patient safety and care quality issues, this is one of the reasons why healthcare is so expensive…
To be clear – handoffs WITHIN a hospital (or care system) count as transitions, too, right?
A recent position statement from the American Geriatrics Society defines transitional care as follows:
For the purpose of this position statement, transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location.
Representative locations include (but are not limited to) hospitals, sub-acute and post-acute nursing facilities, the patient’s home, primary and specialty care offices, and long-term care facilities.
Transitional care is based on a comprehensive plan of care and the availability of health care practitioners who are well-trained in chronic care and have current information about the patient’s goals, preferences, and clinical status. It includes logistical arrangements, education of the patient and family, and coordination among the health professionals involved in the transition.
Transitional care, which encompasses both the sending and the receiving aspects of the transfer, is essential for persons with complex care needs.
Source: Coleman EA, Boult CE on behalf of the American Geriatrics Society Health Care Systems Committee. Improving the Quality of Transitional Care for Persons with Complex Care Needs. Journal of the American Geriatrics Society. 2003;51(4):556-557.
via http://www.caretransitions.org/
I took the liberty of breaking up that big gray block into digestible pieces. Gee whiz, some organizations like to wrbite like lawyers. Fine with me, except that it makes it hard for ordinary mortals to contribute, or even to understand! :)
AND, having done so, I now assert that the definition is incomplete for our purposes: it doesn’t address handoff of care within a location, even within a floor, e.g. at shift change. (Right?)
I’m telling you this because I can’t be in the sessions tomorrow and you are hereby deputized to holler about this as my proxy. ANY situation where Worker A has a relevant fact, and Worker B doesn’t receive it, is a breakdown – a failure to carry forward a valuable asset that affects quality of care!
Regina Holliday recounts numerous instances of facts buried in the paper folder not being apparent to later workers. What is the difference between that transition failure (within a department) and failure between departments or locations? In both cases the downstream worker is disabled and the patient is put at risk.
[At a more technical level, this line of thought leads quickly to the need not just to convey the facts, but to present them in a way that gets the receiving worker’s attention. That’s what Regina had in mind with her first mural, Medical Facts. But that’s a rant for another day…]
“Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location.”
Yeah, I got that re different *levels* of care, and about transfers. But I don’t want folks to overlook transitions (handoffs) that do NOT include a transfer of any sort.
As I’m sure you know, it’s been well documented that a radical innovation reduced errors: having shift change at the bedside, so the patient and family can listen. Know what that means? Important info ain’t gettin’ handed off between shifts automatically. Repeat that for a few shifts, and you have a game of “Telephone – Medical Edition.” Egad.
Hey..
I am absolutely agree with Brian Ahier point of view… And thanks for you to sharing such a nice stuff… carry on..
Wow, that is so crazy! In this world of technology these things should be up to date!!! I am glad that your “super-sisters” were able to be on top of your moms health!