Morning report decreases length of stay in trauma patients

Wolfe, John D; Gardner, James Reed; Beck, William C.; Taylor, John R.; Bhavaraju, Avi; Davis, Ben; Kimbrough, Mary K.; Robertson, Ronald D.; Karim, Saleema A.; Sexton, Kevin W.

doi:10.1136/tsaco-2018-000185

Cited by 3 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patients discussed have a plan of care formulated with input from all teams in attendance. [17] During this same period, there were no other significant lab, operational, or faculty changes made. The role of the current study was to determine the impact of this newly implemented MR model on surgical EGS patient outcomes.…”

Section: Introductionmentioning

confidence: 93%

Morning report decreases length of stay in emergency general surgery patients

Gardner

Wolfe

Beck

et al. 2019

JHA

Self Cite

View full text Add to dashboard Cite

Objective: Communication in the hospital setting is an easy target for quality improvement. Capturing this change via communication between providers during hand-offs is necessary to reduce delays and errors. While this process has been more widely characterized in medical specialties, we designed this study to address the knowledge gap in surgical specialties.Methods: Our institution’s division of Acute Care Surgery (ACS) implemented Morning Report (MR) in October of 2015. At MR, all admissions and service transfers were discussed from Trauma, Emergency General Surgery (EGS), and Surgical Critical Care services from the previous 24 hours. This study compared patients who underwent a surgical procedure during their hospital stay before and after protocol implementation.Results: 974 patients were included in this study. The average patient was 50.3 years of age, 65.4% were white, and 51.7% were male. The average length of stay (LOS) was 8.3 days with 1.75 days to procedure. The post-MR cohort LOS was 2.7 shorter and had 0.85 fewer days to procedure. In an adjusted regression analysis, days to procedure and LOS decreased by 33% (p < .01) and 17% (p < .01) respectively.Conclusions: Implementation of MR led to a decrease in the overall LOS and days to procedure for operative patients. Our results advocate for the standard use of structured hand-offs in surgical units.

show abstract

Section: Introductionmentioning

confidence: 93%

Morning report decreases length of stay in emergency general surgery patients

Gardner

Wolfe

Beck

et al. 2019

JHA

Self Cite

View full text Add to dashboard Cite

show abstract

Physician inpatient handoffs—Patient and physician outcomes: A systematic review

Allen‐Dicker,

Kerwin,

Wallins

et al. 2024

Journal of Hospital Medicine

View full text Add to dashboard Cite

BackgroundPrior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326).MethodsPubmed, Embase, and Cochrane Central Register of Controlled Trials were searched on January 13th, 2022. We included experimental or quasi‐experimental studies that examined handoff communication between inpatient physicians and reported patient clinical, patient experiential, physician experiential, or cost and utilization outcomes. Studies were excluded if they examined handoffs between facilities or levels of care, or only reported subjective measures of patient safety or physician experience. Risk of bias was assessed using the ROBINS‐1 and RoB‐2 tools.ResultsOf the 42 included studies, six were randomized controlled trials. Most studies were conducted at academic centers (67%) and involved only residents (64%). An educational intervention was used in 52% of studies and a structural intervention was used in 43%, with 9% using both. Adverse events were significantly improved in three of 16 studies, medical errors in three of seven studies, and length of stay in three of seven studies. Four studies examined mortality, and none reported a significant improvement. Studies that used both structural and educational components reported significant improvements more frequently.ConclusionsThe literature is mixed on the impact of efforts to improve handoffs, though there are few randomized trials. Few studies reported patient experiential or cost/utilization outcomes, or involved hospitalist physicians, which represent potential areas for future research.

show abstract