A Workflow Solution

Standardized Hand off Report Between the Emergency Department and Inpatient Nursing Units

As healthcare becomes more specialized, with an increased use of technology and more healthcare clinicians involved in patients care there is a greater chance of ineffective hand offs. The transfer of necessary patient information regarding care is essential. When shift changes occur or a patient is transferred to another unit, nurses are expected to complete a hand off of patient information (Halm, 2013). The emergency department transfers a large number of patients to inpatient nursing units. Unfortunately there are a high number of nurses working in an ED often with different ways of handing off patients. A workflow issue exists when Information for patient hand off between units is not standardized, inconsistent or incomplete. This workflow issue creates gaps in care and greatly effects patient safety. Inadequate information jeopardizes patient care. There is a potential for adverse medication events or harmful care to patients (Patterson & Wears, 2010). The solution to the issue is a standardized report such as SBAR that can be incorporated into the EMR used by the facility for nursing hand off. Each SBAR report would offer the same information pieces. Some examples include important patient identifiers, diagnoses, history, assessments, treatments and medications. Nurses can add or edit important information about the patient that the oncoming nurse can use as a reference. The impact of this resolution on patient workflow is that patient safety and continuity of patient care are ensured. There is a safe passage of information for the next nurse to increase effectiveness of patient care. There are fewer errors and increased patient satisfaction. Overall, it is a more effective use of of the nurse's time (Friesen, White, & Byers, 2008).

 

Here are a few strategies to improve patient hand-offs!!!

Besides SBAR, another tool that available for paient hand-offs is SHARE. Solving Handoff Problems with SHARE


References:

Friesen, M. A., White, S. V., & Byers, J. F. (2008). Handoffs: Implications for nurses. Patient Quality and Safety: An Evidence-Based Handbook for Nurses. Retrieved February 17, 2015 from http://www.ncbi.nlm.nih.gov/books/NBK2649/?report=printable

Halm, M. (2013). Nursing handoffs: Ensuring safe passage for patients. American Journal of Critical Care, 22(2), 158-162.

Patterson, E. S., & Wears, R. L. (2010). Patient handoffs: Standardized and reliable measurement tools remain elusive. The Joint Commission on Accrediation of Healthcare Organizations, 36(2), 52-61.