Development and testing of a standardized communication form to improve transitions for nursing home residents
A communication form was developed and pilot-tested in a sample of transitions from nursing homes to the emergency department and back. Elements of the communication form were informed by previous research and include essential medical information, reference to documents and personal assistive devices.
Findings: (1) A finding with significant implications for the future success of this communication form is that one of the two pages is often lost. As such, we have recommended to AHS that the two pages be joined on their long (vertical) edge and open like a book. AHS has verbally confirmed that this change will be adopted. (2) 90 forms were collected during the study implementation period. The two-page communication form was used in approximately 39% of transfers identified by the research assistants. 65% of forms collected had the LTC sending information section completed in whole or in part. 17% of forms were filled out in whole or in part by care providers in more than one care setting. An additional 18% of forms were spoiled, as they were missing one of the two required pages.
Impact of findings: The inter-facility patient transfer form is being launched provincially by Alberta EMS and is expected to be used for all patient transfers. Upon recommendation from the research team, Alberta Health Solutions has joined the two pages of the IFPT form along the long edge so that it is more difficult to lose one of the two pages (as happened in 18% of pilot study cases).
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About the Project
One of the key findings from the Older Persons’ Transitions in Care (OPTIC) study is the need to improve communication among health care providers involved in the handover of frail elderly residents during transfers to and from the emergency department. These transitions from long term care to emergency departments and back are facilitated by personnel from emergency medical services, long-term care and the emergency department.
Considering the many different types of healthcare personnel involved in these handovers, some information as simple as whether a resident owns eyeglasses, dentures, walking aids, etc. is often missed in documentation. Thereby, these personal assistive devices may not accompany the resident to the emergency department and back or possibly become lost during the transition. This failure to protect the vulnerable elderly resident and their belongings can leave them frightened and feeling unable to communicate at their assisted capacity.
Based on the pilot-test mentioned above, we hoped to confirm that a communication form used by all health care providers during transitions of care improves communication, resulting in better care for the frail elderly resident.
For more details on the project rationale and objectives, click here.
Greta Cummings, PhD, RN, FCAHS -- University of Alberta
Garnet Cummings, BPE, MSc, FRCP, FACEP, EMDM -- University of Alberta
Carole Estabrooks, RN, PhD, FCAHS -- University of Alberta
Colin Reid, PhD, MA, BA -- University of British Columbia
Brian Rowe, MSc, CCFP(EM), MD, BSc -- University of Alberta
Adrian Wagg, MB, BS, FRCP, FHEA(MD) -- University of Alberta
Knowledge Users and Partners:
Carol Anderson, MScN -- Baycrest Centre for Geriatric Care
Ann Chiovetti, RN, BN, MHS -- Alberta Health Services
Karen Latoszek, RN, ENC(c) -- Alberta Health Services
Lorie-Ann Little -- National Initiative for the Care of the Elderly
Garnet Munro, MBA -- Alberta Health Services
Project Contact: Greta Cummings -- email@example.com
Key words: transitions; communication; continuity of care; nursing homes; emergency department