Improving Communication Through Discharge Education of Initial Burn Management for Patients Awaiting Outpatient Burn Clinic Follow-up

Background: There has been a decrease in burn injuries due to public awareness and safety efforts, thereby limiting providers' experience with assessment, management, and familiarity with the American Burn Association (ABA) referral criteria to verified burn centers. Inexperience can lead to unnecessary medical interventions, inappropriate transfers, increased costs, and adverse patient outcomes. Rural communities are especially vulnerable as there is limited access to verified burn centers, resources, and technology. The literature demonstrates the need for additional education and resources for referring providers caring for burn patients. Local Problem: During a review of the burn call referral process with the leadership team of the University of Utah's ABA-verified burn center, the staff identified a gap in communication, education, and available resources between it and its referring providers. The team prioritized the clinical problem and requested a modification of the current process to incorporate a standardized discharge patient education handout for patients awaiting burn clinic follow-up. The previous burn call referral process utilized verbal communication of initial burn management between the University of Utah's ABA-verified burn center and its referring providers. For patients not requiring inpatient admission, the burn provider provides care recommendations to the charge nurses, who then communicate the recommendations to the referring providers. Methods: A qualitative analysis of the charge nurse group was utilized to assess perceptions and barriers of a standardized discharge patient education handout during the referral process. Data was collected over ten weeks from an electronic telephone intake form to evaluate the frequency and use of the handout. A post-assessment evaluation assessed the revised process's usability, feasibility, satisfaction, and recommendations for future implications. Interventions: A standardized discharge patient education handout was created from existing evidence-based resources and additional University of Utah Burn Center outpatient resources. A modified workflow was implemented to incorporate a standardized discharge patient education handout that could be sent via fax or email. Results Overall compliance with the modified referral process and the utilization of the discharge patient education handout was 49%. High satisfaction for usability (94%) and feasibility (94%) were reported by the charge nurses. One hundred percent of the stakeholders agree that the discharge patient education handout is a valuable resource and approve of the modified process. Stakeholders intend to continue using the discharge patient education handout beyond the implementation of this project. Additionally, they provided suggestions for revision to the discharge patient education handout, which included instructions for wound care for chemical burns, frostbite, face care, and alternative topical treatments. Conclusion The discharge patient education handout is a valuable resource for improving communication between the burn center and its referring providers. The data demonstrates a disconnect between the overwhelming satisfaction of the project and the stakeholder's compliance. Additional assessments will be necessary to identify the underlying limitations of the modified referral process to improve compliance. The next phase of this project will include the evaluation and satisfaction of the discharge patient education handout by the referring providers and patients awaiting burn clinic follow-up.