Disclosures: Steven D. Hansen, DO: Nothing to disclose

Objective: Implement a minimalistic sign-out from acute hospitalization to inpatient rehabilitation to improve continuity of care, reduce of adverse outcomes, and prevent loss to follow up.

Design: Quality Improvement

Setting: Tertiary care hospital, acute inpatient rehabilitation.

Participants: Acute care discharging team, rehabilitation admitting team.

Interventions: A system of sign-out was implemented from acute hospitalization to inpatient rehabilitation, initially from all services without targeted focus over a 2-month period, secondarily from orthopedic service focusing on weight bearing status, wound care, and follow up over an additional 2-month period. Sign-out was defined as verbal discussion from discharging provider to admitting physician. Initial intervention focused on universal sign-out discharging to admitting team, focusing on sign-out occurrence and timing. A subsequent intervention focused on sign-out from patients on the orthopedic service, with sign-out documentation focused specifically on weight bearing status, wound care, and follow up.

Main Outcome Measures: Percentage of patients for whom sign-out was obtained and properly documented.

Results: Preliminary data collection after implementation of universal sign-out, as defined as verbal discussion from discharging provider to admitting physician, demonstrated 88.9% of patients arriving to floor after sign-out obtained, 4.3% of patients arriving after sign out, and 6.7% not having sign-out during stay, over a 2-month data collection period. Secondary data collection of focused sign-out from orthopedic service over a 2-month period of 20 patients from orthopedic service demonstrated 100% sign-out and documentation of weight bearing status, wound care, and follow up. Further analysis 6 months after intervention, over a 2-month period, demonstrated 8 patients admitted from orthopedic service, with documentation containing 100% of patients’ weight bearing status, 87.5% of patients’ follow up, and 37.5% of patient’s wound care.

Conclusions: Implementation of a minimalistic sign-out from acute hospitalization to acute inpatient rehabilitation is obtainable and can be focused on specific aspects of patient care.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/continuity-of-care-from-acute-hospitalization-to-inpatient-rehabilitation-a-quality-improvement-project/