Improving the neonatal team handoff process in a level IV NICU: reducing interruptions and handoff duration

BMJ Open Quality

article

Vilmaris Quinones Cardona¹  Alison LaBadie¹  David B Cooperberg²  Alan Zubrow¹  Suzanne M Touch¹ 

[1] Division of Neonatology, Department of Pediatrics, St Christopher's Hospital for Children , Drexel University College of Medicine;Division of Hospital Medicine, Department of Pediatrics, St Christopher's Hospital for Children , Drexel University College of Medicine

关键词: hand-off;    graduate medical education;    healthcare quality improvement;    interruptions;    communication;   

DOI  :  10.1136/bmjoq-2020-001014

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background Neonatal intensive care unit (NICU) patients are at increased risk for handoff communication failures due to complexity and prolonged length of stay. We report a quality initiative aimed at reducing avoidable interruptions during neonatal handoffs while monitoring handoff duration and provider satisfaction.Methods Observational time series between August 2015 and March 2018 in an academic level IV NICU. NICU I-PASS and process changes were implemented using plan–do–study–act cycle, and statistical process control charts were used in the analysis. Unmatched preintervention and postintervention satisfaction surveys were compared using Mann-Whitney U tests.Results There was special cause variation in the mean number of avoidable interruptions per handoff from 4 to 0.3 (92% reduction). The mean duration of handoff was reduced ~1 min/patient. Provider satisfaction with the quality of handoffs also improved from a mean of 3.36 to 3.75 on a 1–5 Likert scale (p=0.049).Conclusions Standardisation of NICU handoff with NICU I-PASS and process changes led to the sustained reduction in avoidable interruptions with the added benefit of reduced handoff length and improved provider satisfaction.

【 授权许可】

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