Hosted by The STEP collaborative

Rules You must answer in the form of a question – (we might be a little generous here) You have 5 seconds to answer once you buzz in –(not going to be generous with this one) You lose points for incorrect or absent answers There are 2 role play daily doubles with a 600 dollar maximum wager The winning team gets a secret major prize!

Facts and FiguresWhat am I?What went wrong?

1,2 According to the Joint Commission, “The primary objective of THIS is to provide accurate information about a [patient]'s care, treatment, and services; current condition; and any recent or anticipated changes” at the time of a transition in care.? What is a handoff?

1,3 The responsible party for the handoff or the party receiving the handoff. What is Person (P)?

1,4 Dr. Jones gives a quick presentation of an infant he wants to admit to the hospital with jaundice. Dr. Robins wonders if mom’s blood type is known but before she can ask the conversation has ended. What went wrong? What is No “input (I)” or “Your turn (Y)” portion of handoff?

2,2 According to a study by the University HealthSystems Consortium, patients receiving this measure had a lower incidence of unplanned readmissions within 7 days compared to patients who did not receive this measure What is PCP/Clinic notification of discharge/transfer ?

2,3 This part of the transition determines how well the receiver knows the patient and what they can add to the understanding of the patient’s illness? What is input (I) or Your Turn (Y)?

2,4 DAILY DOUBLE: ROLE PLAY Joe was admitted for pneumonia. He has had 5 prior episodes of pneumonia, 3 episodes of cellulitis, and 1 prior episode of osteomyelitis. Because of his recurrent infections an immune deficiency workup was performed. You and a member of your team must role play the part of the discharging hospitalist and receiving primary physician using PRIMARY. Who is going to take ownership of the follow up of this testing? a role play must make it clear who is going to follow up on these test results

3,2 Between 1995 and 2006, poor handoffs were the leading root cause of these events which are, defined as any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a person or persons, not related to the natural course of illness. Clue: Name means “warning.” What are “Sentinel Events”?

3,3 The concise summary of the key events in the patient’s hospitalization or recent care. What is medical course (M)?

3,4 Upon discharge from the hospital a patient with abdominal pain, Was scheduled for an outpatient open MRI not available in the hospital. No one followed up on the results. The patient subsequently ruptured her abdominal aneurysm at home and died. What went wrong? What is No Responsible party (R) assigned?

4,2 According to a study by Bodenheimer in the NEJM, < 50% of THESE received info about discharge plans/ medications when their patients were discharged from the hospital.. What are Primary Care Providers (PCP)?

4,3 Patient Joe Smith is a 114 year old who was admitted with a hypertensive crisis. His blood pressure has improved and he is now ready for discharge. What is assessment (A) (yes he is 114 years old)?

4,4 When Dr. Johnny Fever discharged Cameron Poe, a 45 year old male newly positive for HIV, Dr. Johnny Dep thought the results were for Cameron Poe, a 25 y/o female. Cameron (female) was shocked when Dr. Dep called her with the news. What went wrong? What is Incomplete identification of the Patient (P)?

5,2 DAILY DOUBLE: ROLE PLAY You (the primary care physician) would like to admit Mary Dementia, an 83 year old with new UTI and worsening confusion who has a past medical history of dementia to your local hospitalist. Her family has been increasingly concerned about her independent function and thinks after admission she needs to live in a supervised setting. You and a member of your team must role play this care transition using PRIMARY. Essential elements of PRIMARY must be performed

5,3 Joe’s renin level is pending and should be back in 3 days. Would you be able to check on that? What is Responsible party (R)?

5,4 Mrs. Robinson was seen in surgery clinic for a planned resection of an intrabdominal mass. The surgeon asked her to go to her primary doctor for pre-operative clearance. Mrs. Robinson saw her primary doctor and talked about her abdominal pain and anxiety and left with analgesic and anxiolytic prescriptions. Surgery was postponed when during the pre-operative checklist it was discovered she was not cleared for surgery. What went wrong? What is no reason (R) for transition explained? (No contact between surgeon and primary doctor)