Selected Podcast
High Acuity Transfers – Guidance Tool for Handoffs-Pediatric Focus
Dana Faber, Patient Safety/Risk Manager at The Doctors Company, moderates this panel interview on high acuity pediatric transfers with Dr. Chrystal Rutledge and Stefanie McKerley.
Featuring:
Stefanie A. McKerley, JD, ARM, CPHRM serves as Manager of Enterprise Risk & Safety at Children’s of Alabama. She has been with Children’s for seven years. Stefanie is responsible for Children’s Enterprise Risk Management program as well as numerous patient safety activities. Stefanie graduated from The University of Alabama with a degree in Anthropology and was a member of the Blount Scholars Program. After college, Stefanie received her Juris Doctor from the University of Mississippi. She recently authored a portion of the CPHRM Exam Preparation Guide and currently serves on the Editorial Review Board for the Journal of Healthcare Risk Management.
Dana Faber is a registered nurse who earned her Associate Degree in Nursing followed by a Bachelor of Science Degree in Business Management. She has also earned a Master of Science in Patient Safety Leadership. Ms. Faber is a Certified Professional in Healthcare Risk Management (CPHRM). She held the office of 2009/2010 President of the California Society for Healthcare Risk Management (CSHRM). Prior to that she acted as the organization’s Communications Chairperson. Dana is the 2020 Deputy Chair for ASHRM’s Patient Safety Committee, a leader in national healthcare risk management stewardship.
Prior to joining The Doctors Company, Ms. Faber worked as a clinical risk manager in an acute care hospital setting. She has over 28 years of healthcare experience and has spearheaded many patient safety initiatives, including correct-site surgery, safe medication management, pressure-ulcer prevention, pathology specimen handling, EHR documentation, electronic incident reporting practices, communication/disclosure, as well as led the hospital’s patient grievance program.
Chrystal Rutledge, MD | Stefanie McKerley, JD, ARM, CPHRM | Dana Faber, MS PSL, RN, CPHRM
Dr. Chrystal Rutledge is a graduate of the UAB School of Medicine in Birmingham, Alabama. She completed her pediatric residency at the University of North Carolina Hospital – Chapel Hill, and her pediatric critical care medicine fellowship at UAB. She is currently an assistant professor of pediatrics within the Department of Pediatrics at UAB in Birmingham, Alabama and an attending physician in the Pediatric Intensive Care Unit at Children’s of Alabama. She is also medical director of Children’s of Alabama Critical Care Transport, medical co-director of the Children’s of Alabama Pediatric Simulation Center and program director for the Children’s of Alabama Community Healthcare Education Simulation Program (COACHES Program). One of her main interests is in the use of simulation to teach the entire spectrum of health care providers and to improve preparedness of community health care workers for critically ill children.Stefanie A. McKerley, JD, ARM, CPHRM serves as Manager of Enterprise Risk & Safety at Children’s of Alabama. She has been with Children’s for seven years. Stefanie is responsible for Children’s Enterprise Risk Management program as well as numerous patient safety activities. Stefanie graduated from The University of Alabama with a degree in Anthropology and was a member of the Blount Scholars Program. After college, Stefanie received her Juris Doctor from the University of Mississippi. She recently authored a portion of the CPHRM Exam Preparation Guide and currently serves on the Editorial Review Board for the Journal of Healthcare Risk Management.
Dana Faber is a registered nurse who earned her Associate Degree in Nursing followed by a Bachelor of Science Degree in Business Management. She has also earned a Master of Science in Patient Safety Leadership. Ms. Faber is a Certified Professional in Healthcare Risk Management (CPHRM). She held the office of 2009/2010 President of the California Society for Healthcare Risk Management (CSHRM). Prior to that she acted as the organization’s Communications Chairperson. Dana is the 2020 Deputy Chair for ASHRM’s Patient Safety Committee, a leader in national healthcare risk management stewardship.
Prior to joining The Doctors Company, Ms. Faber worked as a clinical risk manager in an acute care hospital setting. She has over 28 years of healthcare experience and has spearheaded many patient safety initiatives, including correct-site surgery, safe medication management, pressure-ulcer prevention, pathology specimen handling, EHR documentation, electronic incident reporting practices, communication/disclosure, as well as led the hospital’s patient grievance program.
Transcription:
Introduction:
Welcome to the ASHRM Podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. Visit ASHRM.org/membership to learn more and become an ASHRM member. On this episode, Dana Faber, Patient Safety and Risk Manager at the Doctor's Company leads a panel discussion on handoff communications with Dr. Chrystal Rutledge, a Specialist in Critical Care medicine and Stephanie McKerley, Manager of Enterprise Risk, Safety Risk Management, both from Children's of Alabama.
Dana Faber: Handoff communication is an integral part of healthcare. Throughout the medical continuum inadequate handoff communication is recognized as a potential risk to patients. The complexity of transferring patients to higher acuity care puts these patients at higher risk for communication lapses. Stefanie, you were a part of the ASHRM task force that developed the handoff tool. Can you tell us what is in the actual handoff guide?
Stefanie McKerley: We call it the high acuity patient external transfer handoff guidance tool. So in there it has a general considerations for the receiving and the transferring hospitals or organizations. We talk about what communication is needed, things to consider when choosing transportation. Basically it's a really malleable tool for each organization to use in ensuring that they have a safe transfer of these higher acuity patients. It involves everything from looking at equipment sizes to what you're documenting considering, everything up to choosing whether or not you can use a helicopter in certain weather or if that's even the right choice for your patient.
Dana Faber: Can you tell us why this project was chosen by the patient safety task force?
Stefanie McKerley: This project in particular came about from multiple concerns that I've expressed with ASHRM, things that people said they needed as part of community hospitals, rural hospitals, any organization that does make high acuity transfers to specialized facilities, so we wanted to take a multidisciplinary approach and look at all the different types of high acuity transfers you might see, and make a handoff tool so that these patients can come to these organizations in a healthy and safe way. When we were looking at making this tool, when I had my eyes on the pediatric population, I was thinking, you know, when these kids come into us in bad condition, what do the hospitals from outside or the organizations from outside really need to know ahead of time so these kids can get here safer or quicker? So that's when I spoke with, with Dr. Rutledge about what are the deficiencies we you usually see and then what in in this tool could be used to help in those situations. So that's kind of the background
Michael Carrese: You're listening to the ASHRM Podcast hosted today by Dana Faber of the Doctor's company joined by Dr. Chrystal Rutledge and Stefanie McKerley from Children's of Alabama. The ASHRM Podcast is made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise management. Visit ASHRM.org/membership to learn more and become an ASHRM member.
Host: Dr. Rutledge as a pediatrician champion of your Children's Hospitals system's high acuity handoff initiative. How will this tool help you in meeting the needs of both the transferring hospital care team and the receiving hospital care team and ultimately the pediatric patient?
Dr. Rutledge: I believe this tool has the potential to allow for a seamless transition of care, patients from transferring hospitals to receiving hospitals. As we know, handoffs are very important to ensure the safety of the patient. It'll help to prevent potentially medical errors such as medication errors to ensure appropriate dosages or are being relayed to the receiving hospital. It will also help to standardize the approach to ensuring that all transferring hospitals have thought about different considerations to consider for these patients, as well. It'll help to make sure that communication both written and verbal communication is seamless and also is standardized.
Stefanie McKerley: Yeah, so we know that this tool created by the ASHRM patient safety task force is certainly a modifiable across any care continuum, whether it be the adult patient, pediatric, OB, etcetera.
Host: So Dr. Rutledge, what do you see that hospitals need that are transferring pediatric patients to your hospital in the form of having everything ready and able to transfer? And how does this tool help with that?
Dr. Rutledge: I think Dana, that a lot of the times when we have transfers from hospitals around our State in Alabama, one of the major issues is that these hospitals do not see sick children very often and if you are at a place that doesn't see sick children very often and a sick child comes through the doors, they're deemed critically ill. You know that you need to get that child to more definitive care as quickly as you can. Sometimes your staff may feel like they are not experienced enough in pediatric cases, have enough training to, in order to manage these patients, know the appropriate dosages for medications. A lot of the issues that you don't have when you're taking care of adult patients, that makes them panic a little bit. It makes you more nervous. It gives you, it's a higher anxiety state, and so when you have to transfer a pediatric patient that is more high acuity from those hospitals, it's really helpful to have some sort of standardized format for how that should occur.
That includes how do you communicate to the receiving hospital? What considerations do we need for transferring that patient? For instance, one of the things that's really important to us is knowing the weight of the patient. Having that weight is really key so that we can help guide medication management. We can help guide our transport team to make sure that they have the appropriate amount of fuel for that transfer. If it's by air. There's a lot of really good information that you may need that you don't know you need if you don't take care of pediatric patients on a regular basis. So having tool helps to take away, the memorizing all of the medications that are needed, memorizing all the things you may need for that pediatric patient and gives you really, it's basically a cheat sheet and it's a help. It's a guidance that's a reference tool in order to make sure you have all of that information.
Michael Carrese: You've been listening to the ASHRM Podcast with today's host, Dana Faber of the Doctor's Company, joined by Dr. Chrystal Rutledge and Stephanie McKerley from Children's of Alabama. The ASHRM Podcast is made possible by the American Society for Healthcare Risk Management to support efforts to build safe, trusted healthcare enterprise risk management. Visit ASHRM.org/membership to learn more and become an ASHRM member.
Introduction:
Welcome to the ASHRM Podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. Visit ASHRM.org/membership to learn more and become an ASHRM member. On this episode, Dana Faber, Patient Safety and Risk Manager at the Doctor's Company leads a panel discussion on handoff communications with Dr. Chrystal Rutledge, a Specialist in Critical Care medicine and Stephanie McKerley, Manager of Enterprise Risk, Safety Risk Management, both from Children's of Alabama.
Dana Faber: Handoff communication is an integral part of healthcare. Throughout the medical continuum inadequate handoff communication is recognized as a potential risk to patients. The complexity of transferring patients to higher acuity care puts these patients at higher risk for communication lapses. Stefanie, you were a part of the ASHRM task force that developed the handoff tool. Can you tell us what is in the actual handoff guide?
Stefanie McKerley: We call it the high acuity patient external transfer handoff guidance tool. So in there it has a general considerations for the receiving and the transferring hospitals or organizations. We talk about what communication is needed, things to consider when choosing transportation. Basically it's a really malleable tool for each organization to use in ensuring that they have a safe transfer of these higher acuity patients. It involves everything from looking at equipment sizes to what you're documenting considering, everything up to choosing whether or not you can use a helicopter in certain weather or if that's even the right choice for your patient.
Dana Faber: Can you tell us why this project was chosen by the patient safety task force?
Stefanie McKerley: This project in particular came about from multiple concerns that I've expressed with ASHRM, things that people said they needed as part of community hospitals, rural hospitals, any organization that does make high acuity transfers to specialized facilities, so we wanted to take a multidisciplinary approach and look at all the different types of high acuity transfers you might see, and make a handoff tool so that these patients can come to these organizations in a healthy and safe way. When we were looking at making this tool, when I had my eyes on the pediatric population, I was thinking, you know, when these kids come into us in bad condition, what do the hospitals from outside or the organizations from outside really need to know ahead of time so these kids can get here safer or quicker? So that's when I spoke with, with Dr. Rutledge about what are the deficiencies we you usually see and then what in in this tool could be used to help in those situations. So that's kind of the background
Michael Carrese: You're listening to the ASHRM Podcast hosted today by Dana Faber of the Doctor's company joined by Dr. Chrystal Rutledge and Stefanie McKerley from Children's of Alabama. The ASHRM Podcast is made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise management. Visit ASHRM.org/membership to learn more and become an ASHRM member.
Host: Dr. Rutledge as a pediatrician champion of your Children's Hospitals system's high acuity handoff initiative. How will this tool help you in meeting the needs of both the transferring hospital care team and the receiving hospital care team and ultimately the pediatric patient?
Dr. Rutledge: I believe this tool has the potential to allow for a seamless transition of care, patients from transferring hospitals to receiving hospitals. As we know, handoffs are very important to ensure the safety of the patient. It'll help to prevent potentially medical errors such as medication errors to ensure appropriate dosages or are being relayed to the receiving hospital. It will also help to standardize the approach to ensuring that all transferring hospitals have thought about different considerations to consider for these patients, as well. It'll help to make sure that communication both written and verbal communication is seamless and also is standardized.
Stefanie McKerley: Yeah, so we know that this tool created by the ASHRM patient safety task force is certainly a modifiable across any care continuum, whether it be the adult patient, pediatric, OB, etcetera.
Host: So Dr. Rutledge, what do you see that hospitals need that are transferring pediatric patients to your hospital in the form of having everything ready and able to transfer? And how does this tool help with that?
Dr. Rutledge: I think Dana, that a lot of the times when we have transfers from hospitals around our State in Alabama, one of the major issues is that these hospitals do not see sick children very often and if you are at a place that doesn't see sick children very often and a sick child comes through the doors, they're deemed critically ill. You know that you need to get that child to more definitive care as quickly as you can. Sometimes your staff may feel like they are not experienced enough in pediatric cases, have enough training to, in order to manage these patients, know the appropriate dosages for medications. A lot of the issues that you don't have when you're taking care of adult patients, that makes them panic a little bit. It makes you more nervous. It gives you, it's a higher anxiety state, and so when you have to transfer a pediatric patient that is more high acuity from those hospitals, it's really helpful to have some sort of standardized format for how that should occur.
That includes how do you communicate to the receiving hospital? What considerations do we need for transferring that patient? For instance, one of the things that's really important to us is knowing the weight of the patient. Having that weight is really key so that we can help guide medication management. We can help guide our transport team to make sure that they have the appropriate amount of fuel for that transfer. If it's by air. There's a lot of really good information that you may need that you don't know you need if you don't take care of pediatric patients on a regular basis. So having tool helps to take away, the memorizing all of the medications that are needed, memorizing all the things you may need for that pediatric patient and gives you really, it's basically a cheat sheet and it's a help. It's a guidance that's a reference tool in order to make sure you have all of that information.
Michael Carrese: You've been listening to the ASHRM Podcast with today's host, Dana Faber of the Doctor's Company, joined by Dr. Chrystal Rutledge and Stephanie McKerley from Children's of Alabama. The ASHRM Podcast is made possible by the American Society for Healthcare Risk Management to support efforts to build safe, trusted healthcare enterprise risk management. Visit ASHRM.org/membership to learn more and become an ASHRM member.