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Safe Transitions of Care: Primary Care Practice

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Safe Transitions of Care: Primary Care Practice. Nancy Elder, MD, MSPH. Debbie Graham, MSPH ... Primary care physician wrote referral for 68 year old female ... – PowerPoint PPT presentation

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Title: Safe Transitions of Care: Primary Care Practice


1
Safe Transitions of Care Primary Care Practice
  • Nancy Elder, MD, MSPH
  • Debbie Graham, MSPH
  • John Hickner, MD, MS
  • American Academy of Family Physicians
  • 2004 NPSF Lets Get On With It!
  • May 3-7, 2004

2
Event Report 1
  • 48 year old female with carcinoid syndrome.
    Tumor has not been found as of yet. Discussed
    patient with specialist who agreed to "get her in
    quickly." I am now seeing patient back several
    weeks later and patient has had no contact from
    specialist. Luckily, patient has been relatively
    asymptomatic during the time period. However this
    delay could have led to a worsening of symptoms.
    Contributing factors include poor communication
    from specialist to his scheduling staff, possibly
    specialist "forgot." Further records were sent
    to "remind" specialist--perhaps they were not
    received.

3
Event Report 2
  • Primary care physician wrote referral for 68
    year old female patient to see a specialist. The
    specialist has a very common last name and no
    first name was provided. There were two other
    doctors with the specialist's last name in our
    area. Resulted in delay in entering referral for
    patient who needed to be seen asap due to chest
    pain. Specialist's office could refuse to see
    patient until referral was received.
    Contributing factors include physician may have
    been writing referral while in the room with
    patient and did not have access to specialist
    information.

4
Event Report 3
  • 11 year old male patient recently hospitalized
    for aplastic crisis secondary to sickle cell,
    seen today for follow-up--no discharge summary.
    Time spent obtaining the information delayed
    patient interaction. If the discharge summary
    had ultimately been unavailable during visit it
    would have undermined patient care. Contributing
    factors include poor transfer of information
    between hospital and office.

5
Event Report 4
  • 48 year old female patient here for follow-up.
    My office had received call from cardiologist
    that she had abnormal labs which needed to be
    followed up. However, no communication from
    cardiologist to my office, therefore no lab
    results to discuss. Consequences call placed
    to cardiology office, unable to reach person who
    could provide information, patient rescheduled
    for later appointment. Contributing factors as
    the information should have come from another
    office to ours, it is unclear what happened on
    their end.
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