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Background: With the growth of the hospitalist subspecialty there has been change in the way patients are cared for after they stabilize from their initial presentations. A major part of this change is that more providers--and more facilities--are involved in this subsequent care. This means more hand offs, and, sometimes, less communication about a patients hospital course and subsequent needs. Thus, there is a need to examine this process with an eye for improvement in the quality of care delivered to the patients who engage the system. Methods: The state chapter of American College of Physicians (ACP) convened a task force to address patient safety concerns in the state of New Mexico. Hand offs from acute care hospitals to skilled nursing facilities (SNFs) was identified as an important concern and the need to gather information about this process (especially the ideas of those providers receiving patients in transfer) was identified as a goal. To accomplish this goal, the task force created a 19 question survey and distributed it to 29 medical directors of SNFs 50 New Mexico SNFs. Results: 8/29 (28%) surveys were returned. All respondents were MDs (8/8; 100%) and most worked in urban areas (6/8, 75%). A majority (6/8; 75%) indicated that orders accompanying patients from a transferring facility were used as a guide rather than a definitive prescription for care and these orders were written soon after the patient arrive and often without the benefit of a discharge summary (6/8; 75%). A majority of respondents (7/8; 88%) also indicated they would find a call from a discharging provider useful and that they would like a direct contact number for a discharging provider (7/8; 88%). Finally, a majority of respondents (6/8; 75%) reported they would like certain types of information when a patient is transferred; and all respondents (8/8; 100%) wanted to know a patient's medication list, code status, and functional capacity at discharge. Conclusion: A survey of medical directors of New Mexico's SNFs provides insight into important aspects of the hand off process from acute care hospitals to SNFs. The information provided by the survey offers a path toward improvement in the quality of this process.'


American College of Physicians


Abstract A155 presented at the American Geriatrics Society, 05/16/2014, Orlando, FL. J Am Geriatr Soc 2014;62:S74.