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Table 2 Care transition interventions and intervention characteristics

From: Strategies to measure and improve emergency department performance: a scoping review

Intervention

Intervention Characteristics

Handover Tools

Handover tools standardise communication using a structured information template performed either verbally or nonverbally [28]. For example, Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) is a tool for face-to-face beside handover [27,28,29,30]. Other tools include Situation, Background, Assessment, Responsibilities and Risks, Discussion and Disposition, Read-back and Record (SBAR-DR) model for verbal handoff, Mechanism of Injury/Illness, Injuries, Signs, observations and monitoring, and Treatment given (MIST; DeMIST includes Demographic information to the handover), hospital developed handover tools, as well as written handover, handover added to patients paper chart, and an eSignout step added to the ED dashboard [27,28,29,30].

Bedside Registration

Bedside registration immediately following tirage involves, when beds are available, patients are brought immediately through to the patient care area following triage where they are registered by a clerk whilst simultaneously being assessed by medical staff [19, 31].

Discharge Planning

At a clinical level, discharge planning involves the early planning of patients’ care after discharge [31]

Discharge Communication

Discharge communication should include important information about the illness, verification of comprehension, and tailoring discharge instructions to address areas of misunderstanding [32]. Interventions to improve discharge communication include education or the sharing of information with patients and the different modes through which information is delivered (e.g., video, interactive websites, written, face-to-face), overcoming existing barriers, or providing additional support to encourage a specific behaviour [32].

Discharge Protocols

Closely linked with handover tools, process protocols and guidelines outline procedures and rules clarifying the transfer of responsibility, as well as a structure for handover [27, 29, 30]. Handover training lasting 3 h, covered five rules of communication, case scenario simulation and a handover protocol [29]

Discharge Clinical Roles

A new clinical role in the form of a dedicated offload nurse for triaging and assessing EMS patients [30]. Another role developed to facilitate handover is the nurse discharge coordinator [33]. The nurse discharge coordinator intervention involves the role discussing with the patient, their health care needs, education, referral to outpatient facility, 24 h nurse follow-up, back-up consultation 1 week after discharge [33]