Abstract
Informatics is revolutionizing the way healthcare data is obtained, disseminated, and communicated. Findings in a systematic review by Aronson, Oertle, & Piscotty (2021), show that communication errors are the leading cause of sentinel events in the healthcare system. Each year sentinel events lead to 1.7 billion in costs and more than 250,000 deaths (Aronson, Oertle, & Piscotty, 2021). Nurses need to leverage new informatics tools to improve communication between the interprofessional team. This project aims to teach nurses about the potential benefit of utilizing an electronic handoff report.
Historical Data
At Park Nicollet, handoffs between the emergency department and medical-surgical floor are verbal. Conversations with my Nurse leader indicate that most staff prefer verbal handoffs compared to electronic handoffs. Management has decided to leverage new informatics technology to streamline communication between different units. The primary reason for this change was due to differences in communication and documentation standards between the emergency department and medical-surgical floor.
Analysis of Identified Need
The electronic health record streamlines the communication process between nurses and the interprofessional team. Zhou & Zhang (2016), emphasize that the traditional method of verbal handoffs lacks structure, formality, and reliability. Researchers explain that verbal handoffs can lead to a ‘telephone game’ effect causing misinformation to take place due to the medium of transmission. Although in their infancy, successfully implemented electronic handoff reports have shown to better communication efficacy and transitions in care (Aronson, Oertle, & Piscotty, 2021). In an issue of the Sentinel Alert Event, the Joint Commission highlights hospitals which have seen a reduction in adverse events from using a standardized electronic handoff tool. After employing the Transforming HealthCare’s Targeted Solutions Tool (TST), Bartlett Regional Hospital in Juneau, Alaska, reduced its ineffective handoff by 58.2 percent.
Projection and Evaluation
It may take time for staff to get acclimated to the new handoff process. Continuous feedback from nurses will be key in solving issues that arise from the new guidelines. Within a year of implementing the electronic handoff report, adverse events will drop by at least 10 percent. If the organization fails to meet the benchmark, the handoff report committee will need to analyze the structure and process variables for areas of improvement. The Robust Process Improvenebt tool is a root cause tool offered by the Joint Commission. The handoff comitee may find this tool useful in the implementation of new handoff practices.
Ovie Embu �Concordia University, St. Paul Pre-Licensure Bachelor of Science in Nursing program
References
Aronson, T., Oertle, S. & Piscotty, R. (2021). Key characteristics of a successful EHR-supported e-handoff tool: A systematic review. Online Journal of Nursing Informatics (OJNI), 25(1), https://www.himss.org/resources/online-journal-nursing-informatics.
Benjamin, M. F., Hargrave, S., Nether, K. (2016). Using the Targeted Solutions Tool® to Improve Emergency Department Handoffs in a Community Hospital [Photograph], the Joint Commission Journal on Quality and Patient Safety, 42(3), 107-114. https://doi.org/10.1016/S1553-7250(16)42013-1.
Inadequate hand-off communication. (2017). Sentinel Alert Event., (58), 1–6. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinelevent/sea_58_hand_off_comms_9_6_17_final_(1).pdf?db=web&hash=5642D63C1A5017BD214701514DA00139&hash=5642D63C1A5017BD214701514DA00139
(n.d.). How to become a Nursing Informatics Specialist [Photograph]. Maryville Online. https://online.maryville.edu/online-bachelors-degrees/rn-to-bsn/careers/nursing-informatics-specialist/.
Zou, X.-J., & Zhang, Y.-P. (2016). Rates of nursing errors and handoffs-related errors in a medical unit following implementation of a standardized nursing handoff form. Journal of Nursing Care Quality, 31(1), 61–67. https://doi.org/10.1097/NCQ.0000000000000133.
Figure 2. Patient Handoff Repot. Image from Bing.
Figure 3. Defective Handoffs. Adapted from “Using the Targeted Solutions Tool Improve Emergency Department Handoffs in A Community Hospital”, by M. F. Benjamin, S. Hargrave, K. Nether, 2016, The Joint Commission Journal on Quality and Patient Safety, 42, p. 107-114. Copyright 2016 by The Joint Comission.
Project Design, Planning, and Implementation
OThe project of implementing electronic handoffs will take place in a month. We hope to see positive results within 6 months to a year. Newsletters will be sent out to spread the news. Each unit leader is required to meet with their pool of staff weekly to hear concerns or objections. The goal of the project is to standardize the handoff process and to provide structure to prevent misinformation. Each week a two hour meeting will be held with the nurse educators, nurse leaders, and leaders of other disciplines to deliberate on the project. Nurse leaders will be auditing their units to ensure that new guidelines are being followed. Concurrent and retrospective audits are the main types used.
Figure 4. Team project. Image from Bing.
Figure 5. Leadership Character traits. Image from Bing. .
Impact Nursing Leadership has on Policy
Nursing leaders are in a unique position to influence policy and staffing effectiveness. The nurse leader acts as a mediator between management, nursing staff, and the patient. Nursing leaders promote quality care by role modeling the standards set by the organization. Additionally, the nurse leader can facilitate the implementation of effective policies by collecting data, analyzing data, and acting as a representative for nurses and their patients. The nurse leader’s participation in the quality improvement process helps to improve the care patients receive and staff satisfaction.
I sure wish I’d presented my theory with a poster before I wrote my book.
Nursing informatics and the electronic handoff report
Figure 1. A health worker interacts with technology. Adapted from “Becoming a nurse informatics specialist”. Maryville University. Retrieved December 10,2021, from https://online.maryville.edu/online-bachelors-degrees/rn-to-bsn/careers/nursing-informatics-specialist/. Copyright 2021 by Maryville University.