To improve patient safety through communication among health care professionals, in 2006 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to require a standardized approach to physician‐to‐physician handoff communications. Criteria included an opportunity to ask and respond to questions and face‐to‐face interaction without interruption. The greater frequency and volume of handoffs among hospitalists make this goal challenging. Time, patient care demands, and schedule restraints make face‐to‐face handoffs difficult. This impairs physician satisfaction and compliance.
The purpose of the study was to implement VoiceCare™ technology (recorded patient information) as the foundation of a patient care handoff process.
We are a 9‐physician, 24/7, in‐house, shift‐based program at a 430‐bed tertiary‐care hospital. Before going off shift, a hospitalist records in VoiceCare™ a report on each patient cared for that day. The standardized report includes the patient's name, room number, admitting diagnosis, pertinent medical history, consulting physicians, pending tests for follow‐up, potential problems, and identification of discharge plan. The physician also dictates how he or she can be contacted for any questions up to 3 hours after the end of the shift. Before leaving, the hospitalist meets face to face with the on‐call physician to relay any critical information (unstable patients, etc.) Finally, the hospitalist dictates a separate interim discharge summary on any patient whose hospital day is a multiple of 7.
At the beginning of each shift, the hospitalist listens to the VoiceCare™ report on the patients she or he is assigned to and reviews additional patient information from the integrated computer system. The hospitalist receives a face‐to‐face report on critical information and review questions. If necessary, the transferring hospitalist can be called with any additional questions. Overnight or covering hospitalists can dictate an addendum to an existing VoiceCare™ report or relay that information in person at checkout.
Working with the vendor, a physician‐friendly VoiceCare™ system was created that allows the physician to skip patients, pause, rewind, and dictate addendums.
The new system improved patient safety and provider‐to‐provider communication, increased physician satisfaction, and met the JCAHO 2E requirements for handoffs. Our standardized approach includes face‐to‐face interaction, exceeds the requirement to ask and answer questions, provides up‐to‐date patient information, and allows the receiver of the handoff to review other relevant patient information. Interruptions are kept to a minimum because physicians record and listen to most information when they are ready. This lets the face‐to‐face time be more efficient and limited to critical issues and clarification, further ensuring critical information is not missed. The system's effect on length of stay is being studied.
E. C. Rice, None; M. Hamilton, None.
To cite this abstract:Rice E, Hamilton M. Recorded Patient Care Reports as the Foundation of JCAHO‐Compliant Handoffs That Improve Patient Safety. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 95. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/recorded-patient-care-reports-as-the-foundation-of-jcahocompliant-handoffs-that-improve-patient-safety/. Accessed September 16, 2019.