Turn that frown upside down: implementation of a visual cue improves communication during emergency department to inpatient hand-offs

BMJ Open Quality

article

Beech Burns¹  James Heilman¹  Shana Kusin¹  Laura Chess¹  Mary Elizabeth Tanski¹ 

[1] Emergency Medicine , Oregon Health & Science University School of Medicine

关键词: Quality improvement;    Electronic Health Records;    Patient Handoff;    Continuous quality improvement;   

DOI  :  10.1136/bmjoq-2022-002078

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

When a patient is admitted to the hospital from the emergency department (ED), the ED clinician passes on relevant clinical information to the admitting team to transition care, a process known as patient hand-off and commonly referred to as ‘calling report’. This information exchange between clinical teams is not only important for care continuity but also signifies a transition of care.However, there are unique challenges in this hand-off process given the unpredictability of the busy ED environment, ED boarding and discontinuity in physician, nursing and transportation workflows. These challenges create the potential for gaps in communication and can create patient safety concerns, particularly if a patient is transported to an inpatient bed before hand-off takes place.We set out to determine whether introducing a visual cue on the electronic health record (EHR) ED trackboard to communicate that report had been given would improve hand-off compliance. We sought to improve the utility of the visual cue and compliance of calling report prior to patient transport through a series of several Plan Do Study Act (PDSA) cycles.97% and has been sustained for 84 months. Additionally, we have had zero reported incidents of patients being transported to a hospital bed before physician report was called since implementation.Our study demonstrates that simple visual cues and incorporation of a user-friendly process in the workflow can improve compliance with ensuring report is called prior to patient transfer from the ED. This may have a positive impact on physician communication and patient safety during the admission process.Quality improvementElectronic Health RecordsPatient HandoffContinuous quality improvementData availability statementData sharing not applicable as no datasets generated and/or analysed for this study.http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND