Implementation of a Standardized Acute Care Plan for Complex Care Medicine Service Patients: A Quality Improvement...

Background: Care transition plans, or acute care plans (ACPs), are created specifically for frequent health care utilizers of the Complex Care Medicine Service (CCMS) at a large urban hospital emergency department (ED). Objective: The aims of the project were to develop, implement, and evaluate a standardized CCMS ACP using a multidisciplinary approach to facilitate the transitions-of-care process in the ED. Methods: A quality improvement project, utilizing a before-and-after approach, evaluated the implementation of standardized ACPs among CCMS patients in the ED, including number of standardized ACPs successfully implemented; level of education participation among CCMS providers; ED and CCMS provider feedback from huddles to inform implementation; and final perceptions of CCMS providers regarding project barriers and successes. Results: Prior to implementation, 40 out of 65 CCMS patients' (62%) electronic medical records (EMRs) maintained an existing ACP. Post implementation, all 65 (100%) CCMS patients' EMRs maintained a completed and standardized ACP. All CCMS providers attended project education sessions and huddles and perceived improved patient care as a result. Conclusions: Targeted education huddles can be used to support and improve newly standardized ACPs. Implications for Nursing: Future work should consider whether standardization and improvement in use also suggest better patient outcomes and provider satisfaction.