Inpatient Care Coordination
October 27, 2020 | Healthcare Risk, Quality, & Safety Guidance
Coordinating patient care among various providers and departments within the hospital is a huge challenge. On top of this challenge are various contributing factors that can impede inpatient care coordination, such as communication breakdowns. Organizations that approach internal care coordination as a longitudinal process, rather than as episodic events, can help assure patients that their care is well managed, is a high priority for the organization, and will be personalized to fit their needs.
For its 2015 Deep Dive on care coordination, ECRI Patient Safety Organization (PSO) analyzed 223 patient safety events (including near misses or events that were detected before reaching the patient) reported to ECRI PSO and its partner PSOs between September 2011 and mid-January 2015. Among the results from the analysis, ECRI PSO found the following:
Several events from the analysis are particularly compelling in illustrating the potential or real adverse impact of poor internal care coordination on care delivery and patient safety. Of the 138 inpatient care coordination events, 8 events were identified as causing patient harm (i.e., events that reached the patient and required intervention, prolonged hospitalization, or resulted in death). In one event, for example, a patient's inability to void went undetected when the physician's order to remove the patient's Foley catheter was not acted upon until a day later. When the patient's difficulty with voiding was identified, his hospital stay was extended. Whether the patient would have been discharged earlier if the order was acted upon promptly is unclear from the report.
In another event, a patient experienced complications from medications that were mistakenly given. The medication reconciliation process during the patient's admission from the emergency department (ED) had relied on an outdated medication list from a previous admission, even though the patient's caregiver had brought a current medication list with the patient to the ED.
Other inpatient care coordination events contributed to patient transfers to a higher...