1. Dr. Jeremy Sturgell, MD FACEP FAAEM Barton County Memorial Hospital
EDTC
Dr. Jeremy Sturgell, MD FACEP FAAEM
Barton County Memorial Hospital

2. Need for Improvement
During the initial data collection and implementation of the EDTC project we identified several areas needing improvement in regards to our patient transfer process
We were able to implement a simple and effective strategy to address these areas and improve our EDTC metrics

3. “Documenting the Documentation”
Our main shortcoming was we had no way to explicitly confirm on chart extraction that all the required documentation was sent to the receiving facility during patient transfers
In practice, we knew we were completing these measures on nearly every transfer, we just needed to find a way to capture this process in the medical record

4. “Transfer Checklist”
Our solution was to design a formal checklist that would be completed on every transfer
This checklist would cover all of the elements of the EDTC as well as all relevant documents
This checklist itself would be part of the medical record and would be sent to the receiving facility with the patient as well as scanned and placed in the patient’s EMR

5. Transfer Checklist

6. Summary of Care
Our ED EMR would allow us to explicitly document the sending of a “summary of care” with the patient
This summary is all of the documents (clinical and legal) and data listed on the transfer checklist, and placed in a manila folder for the receiving hospital
We include the transfer checklist itself, as well as an additional copy of the patient’s face sheet

7. Summary of Care

8. Summary of Care

9. Summary of Care

10. Summary of Care

11. Transfer Checklist Archived in the EMR

12. Chart Extraction
Very simple when the EMR indicates a summary was sent—we know the contents of our summary of care packets
The completed transfer checklist has been scanned for later confirmation if necessary
Very rare for a chart to “fall out” due to no proof of the required information being sent with the patient

13. Further Refinement
We engaged our providers (physician and nurses) regarding the EDTC project and provided direct feedback to the provider(s) on any patient transfer that did not satisfy all elements
Implemented a voice dictation system to our EMR that encourages more robust and detailed documentation

14. Teamwork
Our nurse manager works with nursing staff on an ongoing basis to ensure continued success and compliance
Our Director of Quality and Risk Management assists with data compilation
Our medical records staff ensure the transfer checklist is scanned into the EMR

15. Results
Transfer data is randomly collected on 15 transfers monthly (Approximately 40-50% of total monthly transfers)
Goal is for 100% adherence to all elements of the EDTC
All transfers reviewed and discussed at bimonthly department meeting with clinical and administrative staff

16. Results

17. Pearls of Wisdom
Physician engagement and leadership was integral in team collaboration and moving strategy in the right direction to meet goals
A culture emphasizing teamwork was essential to efficiency and quality care
Streamline tools and measurement process

18. Contact Edie Ogden, RN, CHCQM eogden@bcmh.net Phone: (417)681-5106
Director of Quality & Risk Management
Phone: (417)
29 NW 1ST Lane
Lamar, Missouri 64759