Improving the Quality of Care and Communication During Patient Transitions: Best Practices for Urgent Care Centers

摘要

Background: Although high-quality care transitions require timely and accurate communication of clinical information between providers, such communication is inconsistent, and there are few established guidelines outside the hospital setting. Methods: Using a systematic, collaborative quality improvement process, Healthcentric Advisors (Providence, Rhode Island) undertook a multistage approach to define best practices for care transitions in the urgent care setting. This approach entailed review of the medical literature to identify processes that improve care transitions outcomes, gathering of information about clinicians' preferences, and a statewide community meeting with urgent care clinicians and other stakeholders to vet draft guidelines and obtain consensus on the concepts. Results: Because of an inability to identify any guidelines or research that globally addressed care transitions from the urgent care setting, information was gathered from studies on patient discharge instructions and extrapolated from the evidence base available for related settings. The resulting set of eight best practices for urgent care center transitions focuses on clinician-to-clinician communication and patient activation, which can be implemented to establish measurable, communitywide expectations for communication. Conclusion: This set of best practices constitutes the first known guidelines to establish expectations and measures tailored specifically to transitions from the urgent care setting to the emergency department or primary care office. They can serve as a resource and a framework for urgent care clinicians expanding their collaboration with community partners, such as emergency departments and primary care providers, particularly in the context of emerging payment models.