INTERACT II S - Seems different than usual At 30 nursing Nursing Not clear whether Evaluation needed (Interventions to homes, 31 reliability and validity on how tool T - Talks or communicates less Public teaching reduce acute transfers took testing has taken impacts on clinical hospitals O - Overall needs more help care transfers): place over place outcomes at care Community P - Pain new or worsening; participated Stop and Watch period. Four transitions – hospitals less in activities Tool deemed to be (mnemonic) preventable and 27 A - Ate less than usual non-preventable Madan et al. N - No bowel movement in three days; or 2012 diarrhoea 100% of patients D - Drank less transferred to the W - Weight change emergency A - Agitated or nervous, more than usual department were admitted to the T - Tired, weak, confused, or drowsy hospital C - Change in skin colour or condition H - Help with walking, transferring, toileting more than usual I-PASS I - Illness severity; stable, watching, For 278 paediatric Developed from Different paediatric (mnemonic) unstable patient transfers SBAR (Situation, populations need into one hospital, children's Background, to be tested for Sheth et al. P - Patient summary; summary time between hospitals Assessment, utility and efficacy 2016 statement, events leading to admission, verbal hand-off and Recommendation) of tool hospital course, ongoing assessment, Cardiovascular patient transfer plan ICUs Expert advisory decreased from group developed A - Action list; to do list, time line and Acute care units baseline (397 +/- tool ownership; know what is going on, plan 167 minutes) to the for what might happen post-intervention
INTERACT II (Interventions to reduce acute care transfers): Stop and Watch Tool (mnemonic) Madan et al. 2012 S - Seems different than usual T - Talks or communicates less O - Overall needs more help P - Pain – new or worsening; participated less in activities A - Ate less than usual N - No bowel movement in three days; or diarrhoea D - Drank less W - Weight change A - Agitated or nervous, more than usual T - Tired, weak, confused, or drowsy C - Change in skin colour or condition H - Help with walking, transferring, toileting more than usual At 30 nursing homes, 31 transfers took place over period. Four deemed to be preventable and 27 non-preventable 100% of patients transferred to the emergency department were admitted to the hospital Nursing Public teaching hospitals Community hospitals Not clear whether reliability and validity testing has taken place Evaluation needed on how tool impacts on clinical outcomes at care transitions I-PASS (mnemonic) Sheth et al. 2016 I - Illness severity; stable, watching, unstable P - Patient summary; summary statement, events leading to admission, hospital course, ongoing assessment, plan A - Action list; to do list, time line and ownership; know what is going on, plan for what might happen For 278 paediatric patient transfers into one hospital, time between verbal hand-off and patient transfer decreased from baseline (397 +/- 167 minutes) to the post-intervention children's hospitals Cardiovascular ICUs Acute care units Developed from SBAR (Situation, Background, Assessment, Recommendation) Expert advisory group developed tool Different paediatric populations need to be tested for utility and efficacy of tool
Rapid-review-Improving-documentation-at-transitions-of-care-for-complex-patients.docx