The handoff of patient information and care is a vulnerable time during hospitalization. Inadequate communication during handoffs is associated with adverse events and near misses. Although recent guidelines from both the Institute of Medicine and the Joint Commission emphasize the need for standardized patient handoffs, there is limited data on the efficacy of standardized protocols or tools for patient handoffs, In our large inner‐city public hospital, the Department of Medicine manages 14 in patient teams. Each team carries an approximate patient load of 16 patients that equates to roughly 220 daily patient handoffs, or about 80,000 patient handoffs per year. We sought to standardize and improve the information contained within handoffs among residents in the Department of Medicine and to evaluate resident perceptions of handoffs, comparing perceptions of care before and after implementation of an electronic Web‐based tool (Ward Manager™) that allows for structured patient handoffs.
We conducted an initial survey of internal medicine residents to assess their “traditional” practices, perceived problems, and overall satisfaction with the patient handoff process at shift change. We then implemented a structured Web‐based handoff tool, Ward Manager™, to standardize patient handoffs. Medical residents were surveyed at the end of each shift regarding nightly cross‐cover events and confidence in received handoffs. Data for 3 subsequent months were collected and compared to traditional handoff practices. All data were analyzed using (the chi‐square test of independence.
Over 4 months, 290 handoff surveys were distributed to 153 residents with a 70% response rate. Overall, residents utilizing the standardized handoff tool perceived fewer near‐miss events on cross‐cover call than those using traditional handoff practices (23% vs. 57%; P = 0.001), Using a Likert scale, residents were more likely to respond that they were confident or very confident in their patient handoff practices when using the structured handoff tool compared to traditional practices (93% vs. 49% P = 0.001). Standardizing handoffs led to improved adherence to the Joint Commission's stated patient safely goal regarding handoff, as 100% of handoffs utilizing the structured tool contained recommended standardized patient information compared to fewer than 50% in the traditional handoff group (P = 0.001).
Standardization of patient handoffs using a structured Web‐based tool led to more consistent transfer of vital patient information, improved resident satisfaction, and a perception of fewer near‐miss events compared to with traditional handoff practices.
C. Payne, none; J. Stein, none; D. Dressier, none.
To cite this abstract:Payne C, Stein J, Dressier D. Implementation of a Structured Electronic Tool to Improve Patient Handoffs and Resident Satisfaction. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 111. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/implementation-of-a-structured-electronic-tool-to-improve-patient-handoffs-and-resident-satisfaction/. Accessed May 23, 2019.