Assessing the implementation of a bedside service handoff on an academic hospitalist service

Wray, Charlie M; Arora, Vineet M.; Hedeker, Donald; Meltzer, David O.

doi:10.1016/j.hjdsi.2017.06.002

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…To date, the research on nurses’ perceptions of bedside clinical handovers is limited but the research generally documents nurses’ support for this practice (Bradley & Mott, ), despite some concerns about time management (Bruton et al , ; Wray, Vineet, Arora, Hedeker, & Meltzer, ), interruptions (Spooner, Corley, Chaboyer, Hammond, & Fraser, ) and patient confidentiality (Tobiano, Bucknall, Sladdin, Whitty, & Chaboyer, ). Some researchers suggest that bedside handovers are more effective and more time efficient (Eggins et al, ).…”

Section: Introductionmentioning

confidence: 99%

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

et al. 2018

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“…Similarly, patients transitioning between locations17 18 or to home from the hospital may be at risk related to ineffective handoffs 19–21. Evidence-based practices targeting these handoffs have been developed that may improve both communication and patient outcomes 4 5 22–25…”

Section: Introductionmentioning

confidence: 99%

Improving end-of-rotation transitions of care among ICU patients

et al. 2019

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BackgroundHospitalised patients whose inpatient teams rotate off service experience increased mortality related to end-of-rotation care transitions, yet standardised handoff practices are lacking.ObjectiveDevelop and implement a multidisciplinary patient-centred handoff intervention to improve outcomes for patients who are critically ill during end-of-rotation transitions.Design, setting and participantsSingle-centre, controlled pilot study of medical intensive care unit (ICU) patients whose resident team was undergoing end-of-rotation transition at a university hospital from June 2017 to February 2018.InterventionA 4-item intervention was implemented over two study periods. Intervention 1 included: (1) in-person bedside handoff between teams rotating off and on service, (2) handoff checklist, (3) nursing involvement in handoff, and (4) 30 min education session. Intervention 2 included the additional option to conduct bedside handoff via videoconferencing.Main outcome measuresImplementation was measured by repeated clinician surveys and direct observation. Patient outcomes included length of stay (LOS; ICU and hospital) and mortality (ICU, hospital and 30 days). Clinician perceptions were modelled over time using per cent positive responses in logistic regression. Patient outcomes were compared with matched control ‘transition’ patients from 1 year prior to implementation of the intervention.ResultsAmong 270 transition patients, 46.3% were female with a mean age of 55.9 years. Mechanical ventilation (64.1%) and in-hospital death (27.6%) rates were prevalent. Despite high implementation rates—handoff participation (93.8%), checklist utilisation (75.0%), videoconferencing (62.5%), nursing involvement (75.0%)—the intervention did not significantly improve LOS or mortality. Multidisciplinary survey data revealed significant improvement in acceptability by nursing staff, while satisfaction significantly declined for resident physicians.ConclusionsIn this controlled pilot study, a structured ICU end-of-rotation care transition strategy was feasible to implement with high fidelity. While mortality and LOS were not affected in a pilot study with limited power, the pragmatic strategy of this intervention holds promise for future trials.

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“…Poor communication between caretakers is a major contributor to many medical errors and could potentially lead to delays in care and sentinel events [ 3 , 4 ]. Bedside handoff is known to be one of the most common and effective communications servicing transitions between providers [ 5 , 6 ]. Additional studies have shown that patient care transition is more consistent and systemic with the implementation of standard reporting systems [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department

et al. 2018

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BackgroundEmergency department (ED) shift handoffs are potential sources of delay in care. We aimed to determine the impact that using standardized reporting tool and process may have on throughput metrics for patients undergoing a transition of care at shift change.MethodsWe performed a prospective, pre- and post-intervention quality improvement study from September 1 to November 30, 2015. A handoff procedure intervention, including a mandatory workshop and personnel training on a standard reporting system template, was implemented. The primary endpoint was patient length of stay (LOS). A comparative analysis of differences between patient LOS and various handoff communication methods were assessed pre- and post-intervention. Communication methods were entered a multivariable logistic regression model independently as risk factors for patient LOS.ResultsThe final analysis included 1,006 patients, with 327 comprising the pre-intervention and 679 comprising the post-intervention populations. Bedside rounding occurred 45% of the time without a standard reporting during pre-intervention and increased to 85% of the time with the use of a standard reporting system in the post-intervention period (P < 0.001). Provider time (provider-initiated care to patient care completed) in the pre-intervention period averaged 297 min, but decreased to 265 min in the post-intervention period (P < 0.001). After adjusting for other communication methods, the use of a standard reporting system during handoff was associated with shortened ED LOS (OR = 0.60, 95% CI 0.40 - 0.90, P < 0.05).ConclusionsStandard reporting system use during emergency physician handoffs at shift change improves ED throughput efficiency and is associated with shorter ED LOS.

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Assessing the implementation of a bedside service handoff on an academic hospitalist service

Cited by 4 publications

References 29 publications

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study

Improving end-of-rotation transitions of care among ICU patients

Standardized Reporting System Use During Handoffs Reduces Patient Length of Stay in the Emergency Department

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