Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-25T01:18:27.062Z Has data issue: false hasContentIssue false
  • English
  • Français

Maintaining continuity of care: a look at the quality of communication between Ontario emergency departments and community physicians

Published online by Cambridge University Press:  21 May 2015

Andrew P. Stiell ,
Alan J. Forster ,
Ian G. Stiell  and
Carl van Walraven
Andrew P. Stiell
Affiliation:
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ont.
Alan J. Forster
Affiliation:
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ont. Department of Medicine, University of Ottawa, Toronto, Ont.
Ian G. Stiell
Affiliation:
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ont. Department of Emergency Medicine, University of Ottawa, Toronto, Ont.
Carl van Walraven*
Affiliation:
Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ont. Department of Medicine, University of Ottawa, Toronto, Ont. Institute for Clinical Evaluative Sciences, Toronto, Ont.
*
Clinical Epidemiology Program, Ottawa Hospital — Civic Campus, F660 – 1053 Carling Ave., Ottawa ON K1Y 4E9; 613 761-4903, fax 613 761-5351, carlv@ohri.ca

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

To maintain continuity of care when a patient's care is transferred between physicians, continuity of patient information is required. This survey determined how, and how well, Ontario emergency departments (EDs) communicate patient information to physicians in the community.

Methods:

We surveyed Ontario ED chiefs to determine the most common media and methods used for disseminating information. We measured the perceived quality of their system, which was regressed against the hospital teaching status and community size using generalized logits modelling. Finally, we elicited the components of an ideal communication system for the ED.

Results:

One hundred and forty-three (85.6%) Ontario ED chiefs participated. The ED record of treatment was the most commonly used medium (95%). Postal service was the most common (55%) method of disseminating information. Thirty-three chiefs (23%) perceived the quality of communicating patient information from their ED as unsatisfactory or inadequate. This perception was significantly more prevalent in larger communities (excellent v. unsatisfactory [odds ratio (OR) 44.9, 95% confidence interval (CI) 13.9-140] and satisfactory v. unsatisfactory [OR 2.9, 95% CI 1.6-5.1]) and in teaching hospitals (satisfactory v. unsatisfactory [OR 9.7, 95% CI 4.7-20.3]). Seventy-eight percent of responding chiefs felt that patient information should be disseminated using electronic means, either through email or server access.

Conclusions:

To communicate patient information to community physicians, Ontario ED chiefs report that a copy of the ED record of treatment is sent by postal service. More than one-fifth of ED chiefs perceived communication from their department as unsatisfactory or inadequate. Studies that assess the completeness and accuracy of the record of treatment are required as a first step for measuring the quality of patient information communication in the Ontario ED system.

Keywords

continuity of careinter-physician communicationsurvey
Type
ED Administration • L’administration de la MU
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 3 , May 2005 , pp. 155 - 161
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

References

1.Cook, RI, Render, M, Woods, DD. Gaps in the continuity of care and progress on patient safety. BMJ 2000;320:791–4.Google Scholar
2.Gosbee, J. Communication among health professionals. BMJ 1998;316:642.CrossRefGoogle ScholarPubMed
3.Regan, WA. Communications: doctors-nurse-patient triangle. Regan report on nursing law 1983;23:1.Google Scholar
4.Buckingham, JK, Gould, IM, Tervitt, G, Williams, S. Prevention of endocarditis: communication between doctors and dentists. Br Dent J 1992;172:414–5.CrossRefGoogle ScholarPubMed
5.van Walraven, C, Seth, R, Laupacis, A. Hospital discharge summaries infrequently get to post-hospitalization physicians. Can Fam Physician 2002;48:737–43.Google Scholar
6.van Walraven, C, Weinberg, AL. Quality assessment of a discharge summary system. CMAJ 1995;152:1437–42.Google ScholarPubMed
7.Mageean, RJ. Study of “discharge communications” from hospital. Br Med J (Clin Res Ed) 1986;293:1283–4.Google Scholar
8.Haikio, JP, Linden, K, Kvist, M. Outcomes of referrals from general practice. Scand J Prim Health Care 1995;13:287–93.Google Scholar
9.Stiell, A, Forster, AJ, Stiell, IG, van Walraven, C. Prevalence of information gaps in the emergency department and the effect on patient outcomes. CMAJ 2003;169(10):1023–8.Google ScholarPubMed
10.Taylor, DM, Chappell-Lawrence, J, Graham, IS. Facsimile communication between emergency departments and GPs, and patient data confidentiality. Med J Aust 1997;167:575–8.CrossRefGoogle ScholarPubMed
11.Chan, BTB, Schull, MJ, Schultz, SE. Atlas Report 1993–2000. Emergency department services in Ontario. ICES Atlast Report Series. Toronto: Institute for Clinical Evaluative Sciences; 2001. p. 24–31.Google Scholar
12.Brown, JB, Sangster, LM, Ostbye, T, Barnsley, JM, Mathews, M, Ogilvie, G. Walk-in clinics: patient expectations and family physician availability. Am Prac 1919;202–6.Google Scholar
13.Wass, AR, Illingworth, RN. What information do general practitioners want about accident and emergency patients? J Accid Emerg Med 1996;13:406–8.Google Scholar
14.Harris, MF, Giles, A, O'Toole, BI. Communication across the divide. A trial of structured communication between general practice and emergency departments. Aust Fam Physician 2002; 31(2):197–200.Google Scholar
15.Vukmir, RB, Kremen, R, Ellis, GL, DeHart, DA, Plewa, MC, Menegazzi, J. Compliance with emergency department referral: the effect of computerized discharge instructions. Ann Emerg Med 1993;22(5):819–23.Google Scholar
16.Jansen, JO, Grant, IC. Communication with general practitioners after accident and emergency attendance: computer generated letters are often deficient. Emerg Med J 2003;20(3);256–7.Google Scholar
17.Parshuram, CS, Young, SJ, Phillips, RJ. Communication from a computerized emergency department to general practitioners. J Paediatr Child Health 1998;34(6):591–2.Google ScholarPubMed
18.Williams, MJ, Haley, P, Gosnold, JK. An improved method of communication between computerized accident and emergency departments and general practitioners. Arch Emerg Med 1991;8:192–5.Google Scholar
19.Johnson, PH, Wilkinson, I, Sutherland, AM, Johnston, ID, Hall, IP. Improving communication between hospital and primary care increases follow-up rates for asthmatic patients following casualty attendance. Respir Med 1998;92(2):289–91.CrossRefGoogle ScholarPubMed
20.Sherry, M, Edmunds, S, Touquet, R. The reliability of patients in delivering their letter from the hospital accident and emergency department to their general practitioner. Arch Emerg Med 1985;2(3):161-4.Google Scholar
21.Stiell, IG, Nesbitt, L, Wells, GA, Campbell, S, Nadkarni, V, Berg, R, et al.What are the most important unanswered questions for pediatric cardiac arrest? [abstract]. Can J Emerg Med 2004;6(3):203.Google Scholar
22.Stokes, ME, Davis, CS, Koch, GG. Logistic Regression II: Polytomous response. In: Categorical data analysis using the SAS system. Cary (NC): SAS Institute Inc; 2000. p. 241–70.Google Scholar