IMPLEMENTION OF AN ELECTRONIC HANDOFF REPORT: A QUALITY IMPROVEMENT PROJECT
Creators: name: Ahonen, Angelica Kaisa
Publisher: name: Zenodo
Year: 2017

description: Critical information such as a patient’s vital signs, neurological status, and level of care is exchanged between registered nurses during a patient handoff report. It is imperative that the communication between each registered nurse (RN) is accurate, specific, relevant, and timely. When the care of a patient is transferred from one healthcare provider to another, the patient may experience potential risk because of communication failure. The purpose of this doctoral project was to evaluate patient and nursing satisfaction. The aim of the proposed process was to have a concise communication tool. The use of this electronic handoff tool promotes relevant and timely communication between the Emergency Department (ED) and Medical Telemetry unit. The project product is an electronic handoff tool that is consistent, safe, and efficient. The first step of the intervention process began with the use of the Iowa Model of evidence-based practice. An inter-professional team was created. The team consisted of frontline nurses, educators, administrators, and technicians. The team met to identify practice issues surrounding the current handoff process. The focus group met over a four month period. During these meetings, the ED to floor handoff report was developed. The handoff report is part of the Electronic Health Records (EHR) operating system of Sunrise, Allscripts Corp., Chicago, Illinois (Vawdrey et al., 2013). This is the Electronic Health Records system used at the University California Irvine (UCI). Inservice education was administered to all ED RN’s and Medical Telemetry RN’s on the iv new electronic handoff process. The in-service education was conducted by the medical telemetry nurse manager and the emergency department nurse supervisor. A three-month pilot took place between the ED and Medical Telemetry unit. Data collection began once the electronic handoff report pilot was implemented. The parameters analyzed: (1) Nursing Satisfaction Survey Monkey results; (2) Press Ganey Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Patient Satisfaction-Overall Recommend and Nursing Communication mean scores; (3) Emergency Department pre and post pilot Diversion times. The results from the threemonth pilot were very satisfactory on patient and nursing satisfaction. Statistically significant changes in nursing satisfaction survey scores were observed for both the efficiency of handoffs and overall satisfaction, p &lt; .001. Approximately 3/4 of the participants rated the Electronic Handoff Trial positively (Excellent, Very Good, or Good) while 1/4 of the participants rated it negatively (Fair to Poor). Patient satisfaction HCAHPS survey results observed at post-test demonstrate statistically significant improvements in ratings of both nurses overall and likelihood to recommend, p &lt; .05. A ten-percent increase in patient satisfaction was achieved after the implementation of the pilot. As a result of positive feedback from the use of the ED to floor handoff report, the handoff process was expanded to all units within the hospital. More data will need to be collected by nursing leaders to determine if the ED to floor handoff report will demonstrate an improvement in patient safety, ambulance diversion times, and emergency department throughput.