From: Developing an emergency medicine handoff tool: an electronic Delphi approach
Domain | Element | Round 2 | Round 3 | Round 4 | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | ||
Nonclinical patient information | Patient identification (combination of name, age, and medical record number) | 9.12 | 1.39 | 9.24 | 1.27 | 9.4 | 0.87 |
Location | 8.72 | 2.11 | 8.52 | 1.58 | 8.4 | 1.58 | |
Eligibility for treatment or insurance status | 5.72 | 3.09 | 4.92 | 2.63 | 4.7 | 2.56 | |
Clinical patient information | Ambulatory or chair/bed bound | 6.20 | 2.75 | 5.60 | 2.10 | 5.3 | 1.82 |
Code status | 8.40 | 2.45 | 7.56 | 2.45 | 7.5 | 2.33 | |
Chief complaint history | 9.68 | 0.75 | 9.80 | 0.50 | 9.8 | 0.50 | |
Relevant past history | 8.92 | 1.75 | 8.60 | 1.19 | 8.6 | 1.23 | |
Home medications | 6.64 | 2.66 | 6.00 | 2.42 | 5.8 | 2.30 | |
Allergies | 8.60 | 2.45 | 7.80 | 2.87 | 7.8 | 2.46 | |
Vital signs | 8.80 | 1.87 | 8.20 | 1.78 | 8.0 | 1.88 | |
Physical exam findings | 8.76 | 1.56 | 8.24 | 1.42 | 8.2 | 1.33 | |
Working diagnosis | 9.56 | 0.96 | 9.24 | 1.20 | 9.2 | 1.20 | |
Clinical stability (e.g., stable, borderline, or unstable) | 9.64 | 0.76 | 9.40 | 0.96 | 9.2 | 0.97 | |
Emergency department course | Summary of the results of investigations | 9.28 | 1.90 | 8.52 | 2.18 | 8.4 | 2.16 |
Investigations ordered but pending | 8.72 | 2.28 | 8.00 | 2.24 | 8.0 | 2.09 | |
Treatments given | 9.40 | 1.15 | 9.04 | 1.40 | 9.0 | 1.29 | |
Changes in condition in the ED | 9.36 | 1.52 | 8.72 | 1.81 | 8.4 | 2.06 | |
Consulting services involved | 9.44 | 0.92 | 9.48 | 0.77 | 9.4 | 0.77 | |
Likely disposition plan (home, admission or consultation) | 8.76 | 1.67 | 8.44 | 1.64 | 8.5 | 1.48 | |
Alternate plan (when changes in condition, the results or discussion with consultants are likely to alter the original plan) | 7.44 | 2.35 | 6.80 | 2.14 | 6.8 | 2.06 | |
Identify parts of the plan that need to be completed by the incoming team | 8.60 | 1.94 | 7.80 | 1.89 | 8.0 | 1.58 | |
What has been discussed with the patient or their family? | 7.56 | 2.75 | 7.12 | 2.09 | 7.0 | 1.93 | |
Identify patients who is being handed over but need to be seen as a new patient (e.g., incomplete assessment or challenging presentation) | 9.44 | 1.08 | 9.24 | 1.30 | 9.2 | 1.35 | |
Emergency department status | Identify high-risk patients who may have been referred to other services or are still waiting to be seen | 9.08 | 1.78 | 8.64 | 1.93 | 8.8 | 1.61 |
Identify patients who require isolation | 8.88 | 1.99 | 8.52 | 2.14 | 8.5 | 2.14 | |
Conflicts with patients or families | 7.64 | 2.53 | 6.68 | 2.32 | 6.6 | 2.24 | |
Conflicts or delays with consulting services | 8.52 | 2.08 | 7.88 | 2.05 | 7.8 | 1.55 | |
Waiting status (number of patients, waiting time and acuity) | 6.84 | 2.79 | 6.68 | 2.29 | 7.0 | 1.99 | |
Beds status (e.g., boarding, isolation, and critical care beds) | 7.68 | 2.51 | 7.44 | 2.18 | 7.4 | 1.80 | |
Patients expected to arrive via ambulances or referred from clinics or other facilities | 7.88 | 2.33 | 7.00 | 2.10 | 7.0 | 1.86 | |
Shortages in medications, equipment, or supplies | 7.44 | 3.25 | 6.80 | 3.07 | 6.7 | 2.88 | |
Shortages in staffing | 7.84 | 2.87 | 7.56 | 2.52 | 7.4 | 2.48 |