We explored concepts of high reliability between perioperative disciplines by incorporating a surgical patient handoff tool that builds in "real time." The tool starts building in the pre-operative phase of care, into the operating room and eventually into the post-anesthesia care unit or intensive care unit, ultimately delivering care continuity.
Handoff communication is a Joint Commission National Patient Safety Goal. Ineffective communication between healthcare providers can lead to sentinel events and may be the reason for errors in healthcare. Using an embedded EMR report may lead to improved communication
OR handoff is pressed to achieve stringent turnover times resulting in dissatisfied receiving RNs and unsafe patient care outcomes. Poor handoffs have led to strain in OR and PACU relationships. Verbal bedside report isn't sufficient enough for a safe handoff. Rushing to write down report leads to miscommunications and hesitancy to ask questions. Implementation of efficiently built EMR based tool in conjunction with PACU pause will increase nurse concentration and improve patient safety.
Implementation of efficiently built EMR based handoff that can pull in information from the chart will save time and relieve pressure of rushed handoff at bedside. This quality improvement initiative will have a focus on safety before efficiency. Anesthesia providers can have more efficient continuity of care for provider turnover and break coverage within a single case. A pilot was conducted in North PACU, which has a mix of ambulatory and in-patient cases. The tool was utilized by staff and a survey was collected for feedback.
Evaluation/Outcomes/Results (So what):
The tool was optimized to follow handoff workflow, the tool bridges gaps in communication from the pre-operative phase of care through perioperative disposition. We have seen an improvement in the relationships between Anesthesia and PACU staff, anesthesiologists have been able to provide more efficient continuity of care during case coverage and handoff. We have seen a reduction in our "transitions of care" risk level matrix, and overall, an increase in the management of the PACU patient.
Conclusions/Implications (And now):
YNHHS staff survey revealed gaps in communication between disciplines and phases of care. Incorporating an electronic handoff tool has bridged gaps in communication for perioperative patients; leading to positive patient outcomes, safer handoffs and strengthened interdisciplinary relationships.