title: SynopSIS: integrating physician sign-out with the electronic medical record.
abstract: BACKGROUND
  Safe delivery of care depends on effective communication among all health care providers, especially during transfers of care. The traditional medical chart does not adequately support such communication. We designed a patient-tracking tool that enhances provider communication and supports clinical decision making.
  
  
  OBJECTIVE
  To develop a problem-based patient-tracking tool, called Sign-out, Information Retrieval, and Summary (SynopSIS), in order to support patient tracking, transfers of care (ie, sign-outs), and daily rounds.
  
  
  METHODS
  Tertiary-care, university-based teaching hospital.
  
  
  METHODS
  SynopSIS compiles and organizes information from the electronic medical record to support hospital discharge and disposition decisions, daily provider decisions, and overnight or cross-coverage decisions. It reflects the provider's patient-care and daily work-flow needs.
  
  
  RESULTS
  We plan to use Web-based surveys, audits of daily use, and interdisciplinary focus groups to evaluate SynopSIS's impact on communication between providers, quality of sign-out, patient continuity of care, and rounding efficiency.
  
  
  CONCLUSIONS
  We expect SynopSIS to improve care by facilitating communication between care teams, standardizing sign-out, and automating daily review of clinical and laboratory trends. SynopSIS redesigns the clinical chart to better serve provider and patient needs.
authors.affiliation: Department of Medicine, University of California-San Francisco, San Francisco, CA. 94143-1211, USA. urmimala@stanfordalumni.org
authors.forename: Urmimala
authors.initials: U
authors.lastname: Sarkar
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Carter
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Omachi
authors.forename: Arpana R
authors.initials: AR
authors.lastname: Vidyarthi
authors.forename: Russell
authors.initials: R
authors.lastname: Cucina
authors.forename: Seth
authors.initials: S
authors.lastname: Bokser
authors.forename: Erik
authors.initials: E
authors.lastname: van Eaton
authors.forename: Michael
authors.initials: M
authors.lastname: Blum
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration; D017144:Focus Groups; D005568:Forms and Records Control / Q000379:methods; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000295:instrumentation*; D019982:Organizational Case Studies; D015397:Program Evaluation / Q000379:methods; D011785:Quality Assurance, Health Care; D012495:San Francisco; D012985:Software Design