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• W3119327019 abstract "<h3>Importance</h3> Patient transitions from hospitals to skilled nursing facilities (SNFs) require robust information sharing. After a decade of investment in health information technology infrastructure and new incentives to promote hospital-SNF coordination in the US, the current state of information sharing at this critical transition is unknown. <h3>Objective</h3> To measure the completeness, timeliness, and usability of information shared by hospitals when discharging patients to SNFs, and to identify relational and structural characteristics associated with better hospital-SNF information sharing. <h3>Design, Setting, and Participants</h3> Survey of 500 SNFs from a US nationally representative sample (265 respondents representing 471 hospital-SNF pairs; response rate of 53.0%) that collected detailed data on information sharing that supports care transitions from each of the 2 hospitals from which they receive the largest volume of patient referrals. Survey administration occurred between January 2019 and March 2020. <h3>Main Outcomes and Measures</h3> Overall assessment of information completeness, timeliness, and usability using 5-point Likert scales. Detailed measures, including (1) completeness—routine sharing of 23 specific information types; (2) timeliness—how often information arrived after the patient; and (3) usability—whether information was duplicative, extraneous, or not tailored to SNF needs. In addition, 8 relational characteristics (eg, shared staffing, collaborative meetings, and referral volume) and 10 structural characteristics (eg, size, ownership, and staffing) were assessed as potential factors associated with better information sharing. <h3>Results</h3> Of 471 hospital-SNF pairs, 64 (13.5%) reported excellent performance on all 3 dimensions of information sharing, whereas 141 (30.0%) were at or below the mean performance on all dimensions. Social status (missing in 309 pairs [65.7%]) and behavioral status (missing in 319 pairs [67.7%]) were the most common types of missing information. Receipt of hospital information was delayed, sometimes (159 pairs [33.8%]) or often (77 pairs [16.4%]) arriving after the patient. In total, 358 pairs [76.0%] reported at least 1 usability shortcoming. Having a hospital clinician on site at the SNF was associated in multivariate analysis with more complete (odds ratio, 1.72; 95% CI, 1.07-2.78;<i>P</i> = .03), timely (odds ratio, 1.76; 95% CI, 1.08-2.88;<i>P</i> = .02), and usable (odds ratio, 1.64; 95% CI, 1.02-2.63;<i>P</i> = .04) information sharing. Hospital accountable care organization participation was associated with more timely information sharing (odds ratio, 1.88; 95% CI, 1.13-3.14;<i>P</i> = .02). <h3>Conclusions and Relevance</h3> In this study, US SNFs reported significant shortcomings in the completeness, timeliness, and usability of information provided by hospitals to support patient transitions. These shortcomings are likely associated with a suboptimal transition experience. Shared clinicians represent a potential strategy to improve information sharing but are costly. New payment models such as accountable care organizations may offer a more scalable approach but were only associated with more timely sharing." @default.
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• W3119327019 date "2021-01-14" @default.
• W3119327019 modified "2023-10-03" @default.
• W3119327019 title "Information Sharing Practices Between US Hospitals and Skilled Nursing Facilities to Support Care Transitions" @default.
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• W3119327019 doi "https://doi.org/10.1001/jamanetworkopen.2020.33980" @default.
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