Abstract
Purpose: The purpose of this quality improvement project is to improve communication and reduce unplanned readmissions between an inpatient hospital setting and an acute inpatient rehabilitation facility. Aim 1: Identify key factors for improving the safety of transfer/handoff. Aim 2: Develop and implement a standardized handoff tool. Aim 3: Evaluate for completion of the standardized handoff tool. Aim 4: Evaluate provider, nursing, and therapist opinions of the new standardized tool as it pertains to patient safety. Aim 5: Determine the number of unplanned readmissions.|Background: Pediatric patients achieve greater outcomes in a pediatric-specific acute inpatient rehabilitation facility. Inter-facility transfer poses the risk of communication errors.|Sample/Setting: The setting for this project was both a 137 bed pediatric hospital and a 14 bed acute pediatric rehabilitation facility [IRF]. The QI project includes patients transferring from inpatient to the selected IRF on first transfer.|Methods: Education was provided to nurse case management regarding the use of standardized hand-off using an auto-populating rehab-focused ISHAPED note built into Epic specific to each patient being transferred. The team of providers had access to this note upon patient transfer. The information included reason for rehab and background illness/injury, PMH, PSH, present condition, medications, diet, and therapy.|Results: Data was collected on a total of 10 patients transferring from the inpatient pediatric hospital to the acute inpatient rehabilitation facility with varying diagnoses. The rehab ISHAPED tool was assessed for completion as well as demographic data. During the data collection phase there were two hospital readmissions for reasons of diarrheal illness and febrile illness.|Conclusion: The transfer of medically complex patients from the inpatient setting to another facility such as an acute IRF poses a great risk for communication error that might affect the patient and related costs. This pilot project will continue to be modified and used to improve patient outcomes, using the ISHAPED handoff tool.