Quality and Patient Safety Research Chair IWK Health Halifax, Nova Scotia, Canada
Background: Information exchange between patients and healthcare providers (HCP) often occurs under less-than-ideal conditions during an emergency department (ED) visit. At the time of discharge, incomplete information or lack of patient comprehension of shared information can lead to inappropriate follow up care, medication errors and unnecessary return visits to the ED. The ED Patient Activated Transition from Care to Home (ED-PATCH) tool was co-designed with patients, caregivers and HCPs to address this communication gap. Objective: The aim of this study was to assess the acceptability, appropriateness and feasibility of the ED-PATCH tool for use in emergency practice settings. Design/Methods: This mixed methods feasibility study was conducted in two urban pediatric EDs in Canada. Caregiver/parent participants were eligible if they or their child were medically stable (CTAS 2-5) and were assessed by a participating HCP. Following ED triage, participants were given a tablet with the ED-PATCH tool to track details about treatments and medications, their diagnosis, and follow up instructions provided during the ED visit. At discharge, HCPs reviewed the data captured in the tool by the caregiver/parent for accuracy and to clarify any incongruences. HCP discharge summary were collected from patient charts for comparison. Caregivers and HCPs completed a 12 item follow up survey to assess acceptability (AIM), appropriateness (IAM) and feasibility (FIM) of ED-PATCH. Results: The average patient census for the two participating ED sites in 2022 were 32,000 and 67,000. Data were collected between July 2022 and August 2023. Of the 190 caregivers/youth approached, 152 (152/190, 80%) agreed to participate and 112 (112/152, 73%) completed the follow-up questionnaire. The average patient age was 6.6 years and the majority identified English as their first language (88.2%). The most common CTAS score was 3 (44.4%). Overall participants reported moderate to high feasibility scores for ED-PATCH, averaging 4.01, 3.99 and 3.91 on AIM, IAM and FIM scales (out of 5), respectively. On exit interviews, HCPs reported the additional time required to review the caregiver-generated discharge summary was valuable to ensure quality communication.
Conclusion(s): Preliminary findings suggest the ED-PATCH tool is feasible in this population. ED-PATCH has the potential to improve recall and comprehension of important information shared during an ED visit.
