Faxed Reports- Does it decrease length of stays in the ED

Jabramac · Apr 6, 2007

We tried it and it didn't work for us. The floor nurses did not necessarily look at the report immediatly and didn't like us bringing pts up until they had actually read through it. So, we ended up either waiting for the floor nurses to call us when they were ready, or we had to call them to follow up and check whether they read report and if they were ready. Both sides were frustrated with faxed reports so we went back to the old way of just calling up, often playing phone tag.

scallisto · Apr 6, 2007

The policy between my floor and the ED is the ED faxes the report and once faxed the ED has the right to bring up the pt. Regardless of getting a call from the nurse or not. At first it was rough, and we all complained (the ED nurses did not of course) but it just became routine and we incorporated it into our practice and now it is just fine. That's my two cents : )

Steph

hogan4736, BSN, RN · Apr 6, 2007

We implemented it to circumvent the floor nurse, who is busy, from answering her phone during her dressing change, and the charge nurse, who is busy fixing everyones "issues"

Why address real problems when we can be impersonal, and fax report...

Leave it to nurses (yes I am proudly a nurse) to deal with real issues indirectly...

Faxing report leads to:

1) omission of important information

2) further separation between the ER and floors

3) continued lack of growth in our profession

bill4745, RN · Apr 6, 2007

It has worked well for us. No phone tag, a written proof of report - no more "he said/she said". When the receiving nurse receives report he/she calls the ER nurse and the pt gets sent up. If no call in reasonable time ER charge calls floor charge.

UM Review RN, ASN, RN · Apr 6, 2007

Our ED faxes report and then follows up with a phone call to the Unit Sec to confirm receipt of the report. The US then is to call the nurse receiving the patient and inform her that report has arrived, so she can get the room and supplies ready. Also at the bottom of the form is an "Estimated Time of Arrival to the Floor" entry. This also helps us.

I like having faxed report because I don't have to deal with personalities as I would in verbal report. As soon as I know I have a patient coming from the ER, I get a name and pull as much info as I can from the computer about that patient, do a brief scan of the labs and reports, and tuck it into the folder. Even if the next shift actually receives the patient, it's helpful information to know and if something's omitted on the faxed report, it'll be there on the labs and test results anyway.

If a patient is really unusual, the ER nurse will supplement with a quick call to the floor to let us know things like, "I ran the blood, it's finished, but you need to give the Lasix" or whatever.

Every system has limitations, but this one just works best for us.

vamedic4, EMT-P · Apr 9, 2007

Faxing report is done frequently at my facility, and much of the time it is a nightmare. ER nurses fax the report and then the unit secretary or someone in ER is SUPPOSED TO call to verify that we received it, but this only happens about 5% of the time (on nights, anyway) and it seems if we have questions we can NEVER speak to the nurse who actually cared for the pt.

What's even more annoying is that the ER will call to tell us that report has been faxed before admitting has called to have a bed assigned. Give me a break!

Unless there is adequate communication between the caregivers in the ER and the caregivers on the floor - something bad is going to happen. It may not happen tomorrow or next week, but I GUARANTEE it will. If we tell you we need 10 minutes, it's because we need ten minutes...maybe to get the room clean, solve another problem, transfer a patient, whatever. We understand when you all need to bring them up NOW, and many times that's fine. But when the NOW patients are 4 to 5 at a time?? :angryfire No way.

We find it easier for the charge nurse to get report if the assigned nurse is busy...and she relays the info to the assigned nurse when care is transferred. This way, a LIVING BREATHING NURSE gets report from another ..preferably the one who cared for the patient. Otherwise we just have some nurse on the other end of the line reading out the orders...ummm, duh...we can read that when he gets up here...what are his breath sounds like?? "....." :trout: Yeah, if it's not done right..it can be downright dangerous.

Tweety, BSN, RN · Apr 9, 2007

It works if the room is ready. We get faxed reports, they call and see if we've received it, and they can bring patients up within 30 minutes, and floor nurses can't stop the process. They dont' wait until the nurse has a chance to review the report if the ER is busy and the patient has to move. The floor nurses are not allowed to obstruct ER transfers. If the ER isn't busy and they floor nurses needs some time the ER is usually willing to wait and doesn't force the issue.

Gigglesforall, BSN, RN · Apr 10, 2007

Our ED does not fax report, gladly. At another hospital I was working at I got a chicken scratch of a "report" that I could not discern anything and could not even fine out what the patient's diagnosis was, lab values, IVs, etc. I like getting report first so I can be prepared to get an NG suction set up, or have the IV pumps on the right side, large adule BP cuff instead of standard, etc. Being prepared with the specific equipment the patient will need before he gets there and is possibly too unstable and I can't leave the room really helps!

caroladybelle, BSN, RN · Apr 10, 2007

Why address real problems when we can be impersonal, and fax report...
Leave it to nurses (yes I am proudly a nurse) to deal with real issues indirectly...
Faxing report leads to:
1) omission of important information
2) further separation between the ER and floors

I agree with the above.

What needs to be addressed is why is staffing so poor that the staff nurse cannot take report. This just avoids addressing the staffing problem.

It also is a problem given that the big current JCAHO/ANA "issue" is that report of any kind should have opportunities to answer and ask questions. If one has time to do that one has time to give oral report. It will be no easier to chase the ER/staff nurse down for questions and answers. We have management insisting on walking rounds and face to face on the floor.....but we will permit faxing report.....it makes no sense.

It also irks when someone has the ER charge give report on a patient that s/he has never cared for. Nothing like asking the SAT % or O2 on a patient being admitted for exacerbation COPD, and the person giving report has no clue/fax doesn't remotely address the admission issue.

RunnerRN, BSN, RN · Apr 11, 2007

We're doing something slightly different (this is just a pilot program, but will probably go fully live within the next few months because it is working great). ER nurse doesn't get a bed number until the bed is clean (no occupied, dirty, or next to be cleaned beds). Each unit has a point person who takes report on all patients, we call their phone and hopefully can give report. Sometimes this person is busy, so we are just told to ask if someone else can take report. If not, then we have a fax form and we fill it out and fax, let the house sup know we're doing this.

The interesting thing about this is that the hospital transporter has 30 min to come get the patient, and we often haven't even called report when they come (if the transporters aren't busy).

This policy has been great; we still get some floor nurses who complain when we say "okay, we'll just fax the report then." They think we're being vindictive, when really we're just following policy. It only takes a few moments to call report and make sure everyone is on the right page, but it takes a lot longer to write the report and fax and call the sup.

PedsER-RN, BSN, RN · Apr 12, 2007

yes, it does help. we've been doing this for a couple years now. when we used to call report, it was always, "can you call back?", or "the nurse taking the report is busy". now, we call and let someone know we're faxing, send it up, and 15 minutes later the pt goes up. they call us if the fax didn't go through and we resend, or copy it and send it through the tube system. we hated doing report by fax at first, but it has really eliminated problems for us, the main one being the floors avoiding taking report so they don't get the pt.