An internet-based communication network for information transfer during patient transitions from skilled nursing facility to the emergency department

J Am Geriatr Soc. 2010 Jun;58(6):1148-52. doi: 10.1111/j.1532-5415.2010.02864.x. Epub 2010 May 7.


Objectives: To determine whether the implementation of an Internet-based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions.

Design: Interventional; before and after.

Setting: ED of an urban teaching hospital with approximately 55,000 visits per year and a 55-bed subacute free-standing rehabilitation facility (the SNF).

Participants: All patients transferred from the SNF to the ED over 16 months.

Intervention: An Internet-based communication network with SNF-ED transfer form for communication during patient care transitions.

Measurements: Nine elements of patient information assessed before and after intervention through chart review.

Secondary outcomes: changes in efficiency of information transfer and staff satisfaction.

Results: Two hundred thirty-four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention.

Conclusion: The use of an Internet-based system increased the amount of information communicated during SNF-ED care transitions and significantly reduced the number of pages in which this information was contained.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Communication*
  • Continuity of Patient Care*
  • Emergency Service, Hospital*
  • Female
  • Hospitals, Teaching
  • Hospitals, Urban
  • Humans
  • Internet*
  • Male
  • Patient Transfer*
  • Skilled Nursing Facilities*
  • Transfer Agreement