title: An internet-based communication network for information transfer during patient transitions from skilled nursing facility to the emergency department.
abstract: OBJECTIVE
  To determine whether the implementation of an Internet-based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions.
  
  
  METHODS
  Interventional; before and after.
  
  
  METHODS
  ED of an urban teaching hospital with approximately 55,000 visits per year and a 55-bed subacute free-standing rehabilitation facility (the SNF).
  
  
  METHODS
  All patients transferred from the SNF to the ED over 16 months.
  
  
  METHODS
  An Internet-based communication network with SNF-ED transfer form for communication during patient care transitions.
  
  
  METHODS
  Nine elements of patient information assessed before and after intervention through chart review.
  
  
  RESULTS
  changes in efficiency of information transfer and staff satisfaction.
  
  
  RESULTS
  Two hundred thirty-four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention.
  
  
  CONCLUSIONS
  The use of an Internet-based system increased the amount of information communicated during SNF-ED care transitions and significantly reduced the number of pages in which this information was contained.
authors.affiliation: Emergency Services Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. husteyf@ccf.org
authors.forename: Fredric M
authors.initials: FM
authors.lastname: Hustey
authors.forename: Robert M
authors.initials: RM
authors.lastname: Palmer
mesh_terms: D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D020407:Internet; D008297:Male; D010360:Patient Transfer; D012866:Skilled Nursing Facilities; D014164:Transfer Agreement