J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 5, May 2018, pages 445-451

Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department

**Table 1.** General Information of Study Patients
	Pre-intervention (n = 327)	Post-intervention (n = 679)
IQR: interquartile range; n: number; ED: emergency department. *Others including transfer to other facilities, left against medical advice, or disposition to jail/police.
Age - years, (mean, IQR)	51 (35 - 62)	51 (37 - 65)
Sex - male yes, (n, %)	173 (53)	342 (50)
ED disposition (n, %)
Discharged to home	165 (50)	286 (42)
Admitted to hospital	155 (47)	367 (54)
Others*	7 (2)	26 (4)

Table 1. General Information of Study Patients

Pre-intervention (n = 327)

Post-intervention (n = 679)

IQR: interquartile range; n: number; ED: emergency department. *Others including transfer to other facilities, left against medical advice, or disposition to jail/police.

Age - years, (mean, IQR)

51 (35 - 62)

51 (37 - 65)

Sex - male yes, (n, %)

173 (53)

342 (50)

ED disposition (n, %)

Discharged to home

165 (50)

286 (42)

Admitted to hospital

155 (47)

367 (54)

Others*

7 (2)

26 (4)

**Table 2.** Physician Compliance With Bedside Rounding Handoff Protocol Relative to Patient Outcomes
	Pre-intervention (n = 327)	Post-intervention (n = 679)	P value
n: number; EMR: electronic medical record; ED: emergency department; LOS: length of stay; min: minutes; IQR: interquartile range. *Others including bedside rounding with nursing staff, residents, or students.
Handoff parameters
Bedside rounding - yes, (n, %)	146 (45)	578 (85)	< 0.001
Written	193 (59)	528 (78)	< 0.001
EMR	245 (75)	629 (93)	< 0.001
Bedside rounding with providers - yes, (n, %)
Oncoming provider only	33 (23)	26 (4.5)	< 0.001
Outgoing provider only	20 (14)	2 (0.4)	< 0.001
Both oncoming and outgoing providers	91 (62)	550 (95)	< 0.001
Others*	2 (1.4)	0	0.106
Patient care outcome measurements
Total ED LOS (min) - median (IQR)	472 (323 - 760)	455 (323 - 643)	0.092
Provider time (min) - median (IQR)	297 (197 - 551)	265 (173 - 438)	< 0.001
Handoff time (min) - median (IQR)	12.5 (7.5 - 12.5)	7.5 (7.5 - 12.5)	0.010
Referral cases - yes (n, %)	22 (6.7)	38 (5.6)	0.478

Table 2. Physician Compliance With Bedside Rounding Handoff Protocol Relative to Patient Outcomes

Pre-intervention (n = 327)

Post-intervention (n = 679)

P value

n: number; EMR: electronic medical record; ED: emergency department; LOS: length of stay; min: minutes; IQR: interquartile range. *Others including bedside rounding with nursing staff, residents, or students.

Handoff parameters

Bedside rounding - yes, (n, %)

146 (45)

578 (85)

< 0.001

Written

193 (59)

528 (78)

< 0.001

EMR

245 (75)

629 (93)

< 0.001

Bedside rounding with providers - yes, (n, %)

Oncoming provider only

33 (23)

26 (4.5)

< 0.001

Outgoing provider only

20 (14)

2 (0.4)

< 0.001

Both oncoming and outgoing providers

91 (62)

550 (95)

< 0.001

Others*

2 (1.4)

0.106

Patient care outcome measurements

Total ED LOS (min) - median (IQR)

472 (323 - 760)

455 (323 - 643)

0.092

Provider time (min) - median (IQR)

297 (197 - 551)

265 (173 - 438)

< 0.001

Handoff time (min) - median (IQR)

12.5 (7.5 - 12.5)

7.5 (7.5 - 12.5)

0.010

Referral cases - yes (n, %)

22 (6.7)

38 (5.6)

0.478

**Table 3.** Association Between Physician Bedside Rounding With and Without the Use of a Standard Reporting System Template Relative to Patient Outcomes
	Pre-intervention	Post-intervention	P value
n: number; EMR: electronic medical record; ED: emergency department; LOS: length of stay; min: minutes; IQR: interquartile range.
Handoff parameters
Communication method - yes, (n, %)
Written	73 (80)	451 (82)	0.68
EMR	84 (92)	541 (94)	0.59
Patient care outcome measurements
Total ED LOS - min, (median, IQR)	484 (324 - 888)	456 (327 - 635)	0.1989
Provider time - min, (median, IQR)	311 (226 - 565)	263 (173 - 435)	0.005
Handoff time - min, (median, IQR)	12.5 (12.5 - 17.5)	7.5 (7.5 - 12.5)	< 0.001
Referral cases - yes, (n, %)	10 (11)	33 (6)	0.078

Table 3. Association Between Physician Bedside Rounding With and Without the Use of a Standard Reporting System Template Relative to Patient Outcomes

Pre-intervention

Post-intervention

P value

Bedside rounding by incoming and outgoing physicians without standard report (n = 91)

Bedside rounding by incoming and outgoing physicians with standard report (n = 550)

n: number; EMR: electronic medical record; ED: emergency department; LOS: length of stay; min: minutes; IQR: interquartile range.

Handoff parameters

Communication method - yes, (n, %)

Written

73 (80)

451 (82)

0.68

EMR

84 (92)

541 (94)

0.59

Patient care outcome measurements

Total ED LOS - min, (median, IQR)

484 (324 - 888)

456 (327 - 635)

0.1989

Provider time - min, (median, IQR)

311 (226 - 565)

263 (173 - 435)

0.005

Handoff time - min, (median, IQR)

12.5 (12.5 - 17.5)

7.5 (7.5 - 12.5)

< 0.001

Referral cases - yes, (n, %)

10 (11)

33 (6)

0.078

**Table 4.** Role of Different Communication Methods Relative to Prolonged Provider Time
Communication method	Adjusted odds ratio	95% Confidence limit	P value
ED: emergency department.
Bedside rounding	1.25	0.80 - 1.94	0.32
Standard reporting system template	0.60	0.40 - 0.90	0.01
Written communication	0.88	0.63 - 1.23	0.45
Electronic medical record	0.89	0.58 - 1.38	0.81

Table 4. Role of Different Communication Methods Relative to Prolonged Provider Time

Communication method

Adjusted odds ratio

95% Confidence limit

P value

ED: emergency department.

Bedside rounding

1.25

0.80 - 1.94

0.32

Standard reporting system template

0.60

0.40 - 0.90

0.01

Written communication

0.88

0.63 - 1.23

0.45

Electronic medical record

0.89

0.58 - 1.38

0.81