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Improving Signout Accuracy and Information Delivery in the Emergency Department (SAID-ED)

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ClinicalTrials.gov Identifier: NCT01859286
Recruitment Status : Completed
First Posted : May 21, 2013
Last Update Posted : May 21, 2013
Sponsor:
Information provided by (Responsible Party):
Justin Mazzillo, The University of Texas Health Science Center, Houston

Brief Summary:
The investigators sought to determine if implementing a standardized sign out process would reduce the amount of medical errors related to patient sign out. The standardized process included the following interventions: implementation of a data resident to review patients lab values, vital signs, radiologist results, and orders in real time, conducting sign out in a standardized location and using the attending physician as an "interruption manager." The investigators defined medical errors related to sign out as any piece of information was incorrectly reported or omitted during sign out that caused a change in treatment or disposition discussed during sign out. The investigators hypothesis was that implementing a standardized sign out process would lead to a decrease in the amount of sign out related errors.

Condition or disease Intervention/treatment
Medical Errors Related to Emergency Department Sign Out Other: standardized sign out process

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Study Type : Observational
Actual Enrollment : 321 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Improving Transfer of Care Accuracy and Information Delivery in the Emergency Department
Study Start Date : February 2012
Actual Primary Completion Date : May 2012

Group/Cohort Intervention/treatment
regular sign out process Other: standardized sign out process
The intervention phase included was the introduction of a standardized TOC (transfer of care) process, which occurred during April and May of 2012. TOC was done at a predefined location in each section of the emergency department (Medicine and Trauma). All participating residents were given a diagram detailing the central location and seating arrangement. The outgoing attending was designated to handle all distractions or disturbances that occurred during sign out. The most senior resident coming on to shift was designated the data resident. The data resident's role was to operate a centralized computer with the ED tracking board and EMR and review pending orders, vital signs and resulted labs and radiology reports after each patient was signed out. A brief pause was implemented to allow the oncoming team to ask any questions regarding that patient's care or course. The post TOC data form and protocol were identical to that of the control phase.




Primary Outcome Measures :
  1. Sign out related errors [ Time Frame: 4 months ]

Secondary Outcome Measures :
  1. perception of sign out [ Time Frame: 1 year after implementation of revised sign out process ]


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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
ED Physicians. We looked at the amount of errors due to signout that ED Physicians commit with standard signout procedure and then with a revised signed out process
Criteria

Inclusion Criteria:

  • ED transfers of care occurring at 0700 or 1900.

Exclusion Criteria:

  • Attending only handovers (1500, 2300)
  • Handovers including midlevel providers (Thursday 0700, 1300).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01859286


Locations
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United States, Texas
Memorial Hermann Hospital - Texas Medical Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
The University of Texas Health Science Center, Houston
Investigators
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Principal Investigator: Nnaemeka G Okafor, MD UT Houston Health Sciences Center at Houston Department of Emergency Medicine

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Responsible Party: Justin Mazzillo, Chief Resident - Emergency Medicine, The University of Texas Health Science Center, Houston
ClinicalTrials.gov Identifier: NCT01859286     History of Changes
Other Study ID Numbers: HSC-MS-11-0655
First Posted: May 21, 2013    Key Record Dates
Last Update Posted: May 21, 2013
Last Verified: May 2013
Additional relevant MeSH terms:
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Emergencies
Disease Attributes
Pathologic Processes