Christian Coletti, M.D., FAAEM, FACP

Medical Director, Wilmington Hospital Emergency Department; Clinical Assistant Professor, Medicine and Emergency Medicine, Jerfferson Medical College

Publications

Altering overuse of cardiac telemetry in non-intensive care unit settings by hardwiring the use of American Heart Association guidelines
Altering overuse of cardiac telemetry in non-intensive care unit settings by hardwiring the use of American Heart Association guidelines
Dressler R, Dryer MM, Coletti C, Mahoney D, Doorey AJ

JAMA Intern Med 2014 Nov;174(11):1852-4

PMID: 25243419

Abstract

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Interunit handoffs of patients and transfers of information: a survey of current practices
Interunit handoffs of patients and transfers of information: a survey of current practices
Kessler C, Scott NL, Siedsma M, Jordan J, Beach C, Coletti CM

Ann Emerg Med 2014 Oct;64(4):343-349.e5

PMID: 24910108

Abstract

STUDY OBJECTIVE: We describe the current state of emergency department to inpatient handoffs and assess handoff best practices between emergency physicians and hospitalist medicine physicians.
METHODS: A survey was distributed electronically to emergency medicine and internal medicine physicians at 10 hospitals across the United States. Descriptive and quantitative analysis was performed on survey results. Additionally, qualitative data were obtained from an expert focus group of both emergency medicine and hospital medicine clinicians.
RESULTS: Seven hundred fifty of 1,799 physicians (42.2%) responded to our Web-based survey. Attending physicians (45%) described themselves as practicing emergency medicine (51%) or internal medicine (56%). Responding residents were 55% internal medicine, 43% emergency medicine, and 13% dual emergency medicine/internal medicine. Of the responding departments, use of standardized tools was reported by less than 20% and only one third of residents reported formal handoff training. Handoff factors identified as important include identifying "high-risk" patients, designating uninterrupted time to perform the handoff, and standardizing information provided during the handoff. Qualitative results mirrored these themes and acknowledged the importance of bedside handoffs.
CONCLUSION: To our knowledge, this is the largest multispecialty survey to date, including both resident and attending physicians in emergency medicine and hospital medicine. Standardized tools are rarely used and training of residents in this critical task is uncommon. Physicians in both specialties agree on the important content and structure of handoff, including the ideal situation of face-to-face bedside discussion. A curriculum and assessment tool for this practice should be developed.
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Patient Satisfaction Surveys and Quality of Care: An Information Paper
Patient Satisfaction Surveys and Quality of Care: An Information Paper
Farley H, Enguidanos ER, Coletti CM, Honigman L, Mazzeo A, Pinson TB, Reed K, Wiler JL

Ann Emerg Med 2014 Mar;

PMID: 24656761

Abstract

With passage of the Patient Protection and Affordable Care Act of 2010, payment incentives were created to improve the "value" of health care delivery. Because physicians and physician practices aim to deliver care that is both clinically effective and patient centered, it is important to understand the association between the patient experience and quality health outcomes. Surveys have become a tool with which to quantify the consumer experience. In addition, results of these surveys are playing an increasingly important role in determining hospital payment. Given that the patient experience is being used as a surrogate marker for quality and value of health care delivery, we will review the patient experience-related pay-for-performance programs and effect on emergency medicine, discuss the literature describing the association between quality and the patient-reported experience, and discuss future opportunities for emergency medicine.
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