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Gillian Saracino



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    OS27 - Integrating the Community Sectors (ID 43)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 5/28/2019, 02:30 PM - 03:30 PM, Pod 6
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      OS27.04 - Discharge Optimization in the Emergency Department at CAMH  (ID 545)

      Gillian Saracino, Performance Improvement, Centre for Addiction and Mental Health; Toronto/CA

      • Abstract

      Purpose/Objectives:
      The CAMH Emergency Department (ED) Discharge Optimization project will improve transitions and experiences of individuals discharged from the ED through: -Implementation of an electronic ?PODS? (Patient Oriented Discharge Summary) that is built within the EMR (Electronic Medical Record) and provided to patients on discharge. -More efficient completion and distribution of discharge summaries to community physicians to promote smooth transitions and continuity of care for patients. These discharge improvements have been successfully rolled out to all inpatient units at CAMH. As a result, this initiative will align with organization-wide standards and initiatives. Further, initial consultation with families as part of the ED Optimization project has acknowledged that a PODS-type discharge summary will fill a reported gap in regards to transition, safety and care planning in the emergency department.


      Methodology/Approach:
      The implementation of PODS will use Project Management tools and approaches within a Quality Improvement Science frame to plan, implement, study and improve: -The use of PODS for patient education and self-management post-ED visit -Efficiencies in completion and distribution of discharge summaries to community Physicians The project team consists of representation and expertise in Project Management, Quality Improvement, and Reporting and Analytics, wherein a measurement plan is being developed to identify current process measures as well as outcome measures. Achievements to date include: -Current state analysis, including process mapping, analysis of variation in current state process, and identification of technical challenges -Current state analysis to inform implementation of PODS in the ED discharge process -Inclusion of patients and families in the planning of PODS for the CAMH ED. -Collaboration with CAMH?s Clinical Informatics team to develop and implement solutions within the CAMH Electronic Medical Record (EMR)


      Finding/Results:
      Currently, this project is underway, with a goal of implementation by the end of the fiscal year. Baseline data collection indicates opportunities for improvement in dissemination of discharge notes from the CAMH ED. Specific areas of opportunity include usability of the EMR function for sending clinical documentation. CAMH-wide implementation of PODS on inpatient units has involved continuous monitoring through initial implementation and PDSA cycles. Currently, there is monitoring for sustainability to ensure continued success of PODS implementation. The same approach will be used for implementation of PODS in the ED.


      Conclusion/Implications/Recommendations:
      The combined implementation of PODS in the ED, and more efficient completion and distribution of ED discharge summaries, will support and maintain a patient-centred approach to promote vital transitions in care.


      140 Character Summary:
      The CAMH Emergency Department is implementing a patient-centred initiative to improve discharge processes and promote more effective transitions in care.