A Novel Transfer of Care Sign-out Assessment Tool in a Pediatric Emergency Department.

A Novel Transfer of Care Sign-out Assessment Tool in a Pediatric Emergency Department.

Acad Pediatr. 2017 Aug 23;:

Authors: Festekjian A, Mody AP, Chang TP, Ziv N, Nager AL

Abstract
OBJECTIVE: Transfer of care sign-outs (TOCS) for admissions from a Pediatric Emergency Department (PED) have unique challenges. Standardized and reliable assessment tools for TOCS remain elusive. We describe the development, reliability, and validity of a TOCS assessment tool.
METHODS: Video recordings of resident TOCS were assessed to capture four domains: completeness, synopsis, foresight, and professionalism. In phase one, 56 TOCS were used to modify the tool and improve reliability. In phase two, 91 TOCS were used to examine validity. Analyses included Cronbach's alpha for internal structure, intraclass correlation (ICC) and Cohen's Kappa for inter-rater reliability, Pearson's correlation for relationships between variables, and 95% confidence interval (CI) of the mean for resident group comparisons.
RESULTS: Cronbach's alpha = 0.52 for internal structure of the tool's subjective rating scale. ICC for the subjective rating scale items ranged from 0.70 to 0.80. Cohen's Kappa for most objective checklist items ranged from 0.43 to 1. Content completeness was significantly correlated with synopsis, foresight, and professionalism (Pearson's r ranged from 0.36 to 0.62, ps < 0.001). Housestaff senior residents scored higher (on average) than interns and rotating senior residents in synopsis and foresight. Also, housestaff interns scored higher (on average) than rotating senior residents in professionalism. Housestaff senior residents scored higher (on average) than rotating senior residents in content completeness.
CONCLUSIONS: We have demonstrated validity evidence to support using scores from the TOCS tool to assess higher level transfer of care comprehension and communication by PED residents and to test interventions to improve TOCS.

PMID: 28843485 [PubMed - as supplied by publisher]

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