title: Standardizing communication from acute care providers to primary care providers on critically ill adults.
abstract: OBJECTIVE
  To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge.
  
  
  METHODS
  A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center.
  
  
  RESULTS
  The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P < .001) and the communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05).
  
  
  CONCLUSIONS
  The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds.
authors.affiliation: Kerri A. Ellis is an assistant clinical professor in the Graduate School of Nursing and an acute care nurse practitioner in the Department of Medicine at UMass Memorial Medical Center, Worcester, Massachusetts. Ann Connolly is a nurse practitioner in the Department of Medicine at UMass Memorial Medical Center. Alireza Hosseinnezhad is a physician in the Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts. Craig M. Lilly is a professor in the Departments of Medicine, Anesthesiology, and Surgery, and in the Clinical and Population Health Research Program at the Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Kerri A
authors.initials: KA
authors.lastname: Ellis
authors.affiliation: Kerri A. Ellis is an assistant clinical professor in the Graduate School of Nursing and an acute care nurse practitioner in the Department of Medicine at UMass Memorial Medical Center, Worcester, Massachusetts. Ann Connolly is a nurse practitioner in the Department of Medicine at UMass Memorial Medical Center. Alireza Hosseinnezhad is a physician in the Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts. Craig M. Lilly is a professor in the Departments of Medicine, Anesthesiology, and Surgery, and in the Clinical and Population Health Research Program at the Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Ann
authors.initials: A
authors.lastname: Connolly
authors.affiliation: Kerri A. Ellis is an assistant clinical professor in the Graduate School of Nursing and an acute care nurse practitioner in the Department of Medicine at UMass Memorial Medical Center, Worcester, Massachusetts. Ann Connolly is a nurse practitioner in the Department of Medicine at UMass Memorial Medical Center. Alireza Hosseinnezhad is a physician in the Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts. Craig M. Lilly is a professor in the Departments of Medicine, Anesthesiology, and Surgery, and in the Clinical and Population Health Research Program at the Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: Alireza
authors.initials: A
authors.lastname: Hosseinnezhad
authors.affiliation: Kerri A. Ellis is an assistant clinical professor in the Graduate School of Nursing and an acute care nurse practitioner in the Department of Medicine at UMass Memorial Medical Center, Worcester, Massachusetts. Ann Connolly is a nurse practitioner in the Department of Medicine at UMass Memorial Medical Center. Alireza Hosseinnezhad is a physician in the Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts. Craig M. Lilly is a professor in the Departments of Medicine, Anesthesiology, and Surgery, and in the Clinical and Population Health Research Program at the Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, Massachusetts. craig.lilly@umassmed.edu.
authors.forename: Craig M
authors.initials: CM
authors.lastname: Lilly
mesh_terms: D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D011320:Primary Health Care