Seattle Children's Hospital
Background: Transitions of patient care often occur before the final diagnosis or outcome is known; physicians follow-up when motivated by curiosity or personal connection and when time allows, without a widely used platform to facilitate learning or to capture patients who experience clinical worsening.
Aims: This quantitative study describes the impact of an automated provider email sent after a patient returns to the ED within 72 hours and is subsequently admitted to an inpatient service. We determined the usefulness of this intervention by identifying (1) the actions taken by the recipient of an email, (2) the rationale for these actions, and (3) their preferences for receiving this type of clinical feedback.
Methods: We conducted an online cross-sectional survey of a convenience sample comprised of 131 pediatric residents, pediatric emergency medicine fellows and attendings at a large, single-site, west coast academic children’s hospital.
Results: Overall response rate was 47%. Residents (100%), fellows (100%), and attendings (95.65%) read the email, with 45.65% indicating the email prompted them to do something different from how they typically follow-up on ED patients. Respondents spent additional time reflecting (84.78%), reviewed the patient’s electronic medical record (73.91%), read more about the patient’s condition (30.43%), discussed the patient’s case with someone else (26.09%), and made changes to their practice (21.74%). For this type of clinical feedback, 82.22% preferred to continue to the current notification system.
Conclusions: Residents, fellows, and attendings find this system educationally helpful for clinical feedback after patient transitions and report changes to their medical practice following the receipt of an automated email.
