Adjusted association of implementation of a standardised accept note with outcomes
| Outcome | Baseline A(n=735) B(n=1004) C(n=856) | Intervention A(n=462) B(n=654) C(n=486) | *Adjusted OR (95% CI) |
| Primary outcome | |||
| Clinician-reported medical errors/100 patient transfers A | 15.8 | 11.5 | 0.73 (0.53 to 0.99) |
| Secondary outcomes | |||
| Clinician-reported failures in communication A | 111.6 | 98.0 | 0.88 (0.78 to 0.98) |
| Presence of accept note, n (%) B | 365 (36.4) | 284 (43.4) | 2.30 (1.75 to 3.02) |
| † Timeliness of accept note (hours), mean (SD) B | 8.7 (3.1) | 21.4 (3.0) | ‡ −12.7 (−9.1 to 16.3) |
| LOS (days), mean (SE) B | 12.2 (0.64) | 12.2 (0.71) | ‡ 0.1 (−0.08 to 0.09) |
| Rapid response or ICU transfer, n (%) C | 69 (8.1) | 22 (4.5) | 0.57 (0.34 to 0.97) |
| In-hospital mortality B | 105 (10.5) | 82 (12.5) | 0.86 (0.57 to 1.29) |
A, B, C Different cohorts were used in analyses based on the outcome: A=all patients included with survey responses; B=entire cohort of patients; C=entire cohort of patients, excluding patient initially transferred to ICU services (Appendix). Boldface OR indicate stastically signficant findings.
*Adjusted for: age, gender, race, ethnicity, insurance, diagnosis on admission, comorbidity (Elixhauser score29), illness severity (eCart score30), clinical service of admission, time of year, admitting team census on date of admission, admitting service census on date of admission, hospital COVID census on date of admission.
†Timeliness of accept note documentation defined as the number of hours between accept note documentation and patient admission (calculated by time of admission – time of accept note documentation).
‡Timeliness of accept note and LOS outcomes show adjusted absolute differences instead of adjusted odds ratio (95% CI).
.ICU, intensive care unit; LOS, length of stay.