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The ED-PACT Tool Initiative: Communicating Veterans' Care Needs After Emergency Department Visits.
- Source :
-
Journal for healthcare quality : official publication of the National Association for Healthcare Quality [J Healthc Qual] 2020 May/Jun; Vol. 42 (3), pp. 157-165. - Publication Year :
- 2020
-
Abstract
- Background: Communication failures between providers threaten patient safety.<br />Purpose: We developed, implemented, and formatively evaluated the ED-PACT Tool, which uses the Veterans Health Administration's (VA) electronic health record to send messages from emergency department (ED) providers to primary care patient-aligned care team (PACT) registered nurses (RNs) for Veterans discharged home from the ED with urgent or specific follow-up needs.<br />Methods: We used Plan-Do-Study-Act quality improvement methodology.<br />Results: Between November 1, 2015, and November 30, 2017, the tool was used to send 4,899 messages in one local VA healthcare system (ED and associated primary care clinics). Formative evaluation revealed that providers and RNs perceive the tool as providing substantial benefit for coordinating post-ED care. Patient-aligned care team leaders reported that RN training and "buy-in" facilitated tool implementation, while insufficient staffing posed a barrier. Emergency department providers noted the advantage of having a standardized and reliable system for communicating with PACTs.<br />Conclusions/implications: The ED-PACT Tool encapsulates several best practices (standardized processes, "closed-loop" communication, embedding into workflow) to facilitate communication between VA ED and follow-up care providers. Our development process illustrates key lessons in quality improvement and innovation implementation including the value of using rapid-cycle improvement methodology, with interprofessional collaboration and representatives from intended spread sites.
- Subjects :
- Adult
Aged
Communication
Female
Humans
Male
Middle Aged
United States
Emergency Service, Hospital standards
Patient Care Team standards
Patient-Centered Care standards
Practice Guidelines as Topic
Quality Improvement standards
United States Department of Veterans Affairs standards
Veterans Health standards
Subjects
Details
- Language :
- English
- ISSN :
- 1945-1474
- Volume :
- 42
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal for healthcare quality : official publication of the National Association for Healthcare Quality
- Publication Type :
- Academic Journal
- Accession number :
- 31008828
- Full Text :
- https://doi.org/10.1097/JHQ.0000000000000195