Transition of care for hospitalized elderly patients - Development of a discharge checklist for hospitalists
Transition of care for hospitalized elderly patients - Development of a discharge checklist for hospitalists
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DOI：
10.1002/jhm.129
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发表时间：
2006-11-01
影响因子：
2.6
通讯作者：
Manning, D.
中科院分区：
文献类型：
--
作者：
Halasyamani, L.;Kripalani, S.;Manning, D.
背景：出院是患者护理的关键过渡点。出院时的不完全关闭可能导致患者发生不良事件，并导致可避免的再住院。护理过渡对于老年患者和其他患有多种合并症的高风险患者尤为重要。标准化出院流程的要素可能有助于解决患者从医院过渡到门诊时出现的质量和安全差距。医院医学协会的医院质量和患者安全委员会召集了一个由护理过渡研究人员、流程改进专家、和住院医师审查文献，并制定一个检查表的过程和要素所需的理想出院的成年病人。出院检查表于2005年4月在医院医学学会年会上提出，并由120多名执业医院医生和医院护士、病例管理人员和药剂师进行了审查和修订。最后的清单是由医院Medicine.RESULTS社会认可：最终确定的清单是一个全面的列表的过程和元素被认为是必要的最佳病人在出院时移交。这份清单侧重于用药安全，患者教育，和后续plannes.CONCLUSIONS：内容和流程标准的发展出院是第一步，提高移交的护理从住院到posthospital设置。针对具有特定诊断、特定年龄类别和特定出院目的地的患者完善该清单可能会进一步改善信息传递并最终影响患者的结果。
BACKGROUND: Discharge from the hospital is a critical transition point in a patient's care. Incomplete handoffs at discharge can lead to adverse events for patients and result in avoidable rehospitalization. Care transitions are especially important for elderly patients and other high-risk patients who have multiple comorbidities. Standardizing the elements of the discharge process may help to address the gaps in quality and safety that occur when patients transition from the hospital to an outpatient setting.METHODS: The Society of Hospital Medicine's Hospital Quality and Patient Safety committee assembled a panel of care transition researchers, process improvement experts, and hospitalists to review the literature and develop a checklist of processes and elements required for ideal discharge of adult patients. The discharge checklist was presented at the Society of Hospital Medicine's Annual Meeting in April 2005, where it was reviewed and revised by more than 120 practicing hospitalists and hospital-based nurses, case managers, and pharmacists. The final checklist was endorsed by the Society of Hospital Medicine.RESULTS: The finalized checklist is a comprehensive list of the processes and elements considered necessary for optimal patient handoff at hospital discharge. This checklist focused on medication safety, patient education, and follow-up plans.CONCLUSIONS: The development of content and process standards for discharge is the first step in improving the handoff of care from the inpatient to the posthospital setting. Refining this checklist for patients with specific diagnoses, in specific age categories, and with specific discharge destinations may further improve information transfer and ultimately affect patient outcomes.