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@article{Johnston:2016:10.1097/SLA.0000000000001164,
author = {Johnston, MJ and Arora, S and Pucher, PH and Reissis, Y and Hull, L and Huddy, JR and King, D and Darzi, A},
doi = {10.1097/SLA.0000000000001164},
journal = {ANNALS OF SURGERY},
pages = {477--486},
title = {Improving Escalation of Care Development and Validation of the Quality of Information Transfer Tool},
url = {http://dx.doi.org/10.1097/SLA.0000000000001164},
volume = {263},
year = {2016}
}

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TY  - JOUR
AB  - Objective: To develop and provide validity and feasibility evidence for the QUality of Information Transfer (QUIT) tool.Background: Prompt escalation of care in the setting of patient deterioration can prevent further harm. Escalation and information transfer skills are not currently measured in surgery.Methods: This study comprised 3 phases: the development (phase 1), validation (phase 2), and feasibility analysis (phase 3) of the QUIT tool. Phase 1 involved identification of core skills needed for successful escalation of care through literature review and 33 semistructured interviews with stakeholders. Phase 2 involved the generation of validity evidence for the tool using a simulated setting. Thirty surgeons assessed a deteriorating postoperative patient in a simulated ward and escalated their care to a senior colleague. The face and content validity were assessed using a survey. Construct and concurrent validity of the tool were determined by comparing performance scores using the QUIT tool with those measured using the Situation-Background-Assessment-Recommendation (SBAR) tool. Phase 3 was conducted using direct observation of escalation scenarios on surgical wards in 2 hospitals.Results: A 7-category assessment tool was developed from phase 1 consisting of 24 items. Twenty-one of 24 items had excellent content validity (content validity index >0.8). All 7 categories and 18 of 24 (P < 0.05) items demonstrated construct validity. The correlation between the QUIT and SBAR tools used was strong indicating concurrent validity (r = 0.694, P < 0.001). Real-time scoring of escalation referrals was feasible and indicated that doctors currently have better information transfer skills than nurses when faced with a deteriorating patient.Conclusions: A validated tool to assess information transfer for deteriorating surgical patients was developed and tested using simulation and real-time clinical scenarios. It may improve the quality and safety of patient care on
AU  - Johnston,MJ
AU  - Arora,S
AU  - Pucher,PH
AU  - Reissis,Y
AU  - Hull,L
AU  - Huddy,JR
AU  - King,D
AU  - Darzi,A
DO  - 10.1097/SLA.0000000000001164
EP  - 486
PY  - 2016///
SN  - 0003-4932
SP  - 477
TI  - Improving Escalation of Care Development and Validation of the Quality of Information Transfer Tool
T2  - ANNALS OF SURGERY
UR  - http://dx.doi.org/10.1097/SLA.0000000000001164
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000370174000008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/58806
VL  - 263
ER  -

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