title: Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review.
abstract: BACKGROUND
  Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care.
  
  
  METHODS
  We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool.
  
  
  RESULTS
  Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26).
  
  
  CONCLUSIONS
  The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA. nluu3@jhmi.edu.
authors.forename: Ngoc-Phuong
authors.initials: NP
authors.lastname: Luu
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Pitts
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Petty
authors.affiliation: Johns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.
authors.forename: Melinda D
authors.initials: MD
authors.lastname: Sawyer
authors.affiliation: Johns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.|Johns Hopkins University School of Nursing, Baltimore, MD, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Dennison-Himmelfarb
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Johns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.|Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA.
authors.forename: Romsai Tony
authors.initials: RT
authors.lastname: Boonyasai
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.|Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA.
authors.forename: Nisa M
authors.initials: NM
authors.lastname: Maruthur
mesh_terms: D000553:Ambulatory Care / Q000592:standards / Q000639:trends*; D003142:Communication; D004632:Emergency Medical Services / Q000592:standards / Q000639:trends*; D004636:Emergency Service, Hospital / Q000592:standards / Q000639:trends; D006282:Health Personnel / Q000592:standards / Q000639:trends*; D006801:Humans; D010045:Outpatients; D010360:Patient Transfer / Q000592:standards / Q000639:trends*
keywords: care transitions; continuity of care; provider-to-provider communication