Critical Access Hospital Use of TeamSTEPPS to Implement Shift-Change Handoff Communication

Abstract

Implementation of handoff as part of TeamSTEPPS ® initiatives for improving shift-change communication is examined via qualitative analysis of on-site interviews and process observations in 8 critical access hospitals. Comparing implementation attributes and handoff performance across hospitals shows that the purpose of implementation did not differentiate between high-and low-performance, but facilitators and barriers did. Staff involvement and being part of the 'big picture' was an important facilitator to change management and buy-in. Keywordscritical access hospitals; communication; Handoff; quality improvement; rural; TeamSTEPPS Since the release of the prominent Institute of Medicine (IOM) report on quality of care and patient safety in US hospitals in 2000, hospitals are increasingly adopting quality improvement (QI) strategies to enhance their performance and facilitate safer patient care. 1

Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals

“…What makes a handoff ineffective is supplying incomplete or erroneous information to the incoming nurse, inefficient methods of communication, and insufficient duration for handoffs, interruptions or disruption of handoffs, absence of standardization of handoff methods, and workforce shortages [ 12 ]. As handoffs are increasingly being recognized as an essential element of patient safety in the United States, Australia, and Europe, stakeholders are making various attempts to standardize primary content and templates for handoffs, developing handoff tools or methods, improving the quality of handoffs, providing an opportunity to ask questions during handoffs, education or training about handoffs, and conducting bedside handoffs [ 13 , 14 ].…”

Barriers and facilitators to implementing priority inpatient initiatives in the safety net setting

“…Prior research on facilitators of hospital improvement efforts have highlighted diverse resource-intensive (e.g., monetary, time) interventions and strategies to promote systems change or teamwork cultures that support change efforts [8,9]. However, little is known about interventions that drive improvements in low-resource settings, such as safety net hospitals (SNH), which may be less able to implement resource-intensive initiatives [10].…”

Assessment of Care Handoffs Among Hospitalist Physicians and 30-Day Mortality in Hospitalized Medicare Beneficiaries

“…Although handoffs have been associated with greater adverse events, prior studies 14 , 24 , 25 of handoffs have largely focused on the trainee setting, despite the fact that handoffs are common in the clinical practice that occurs once physicians complete their training. Hospitalists, for example, now provide most general medical care in inpatient settings and typically work contiguous days in which handoff of patients to another physician occurs at the end of a scheduled block.…”