Objectives: The clinician arriving at the hospital in the morning may not yet be aware of key overnight clinical activity. To address this situation at our facility, we modified our handoff software to permit continuous updating of clinical information and the automatic relay of important overnight clinical updates to relevant providers each morning.
Methods: Cross-covering residents electronically entered safety concerns and clinical issues within the reporting module of the handoff software between 5 PM and 7 AM. This updated their handoff-information at shift change and permitted the generation of reports that were emailed to primary providers and reviewed before 7 AM prerounds. At 7:30 sign-out, if a resident was already aware of an issue being signed out, he/she indicated this so that sign-out could quickly proceed to the next patient. Study sign-out duration was recorded, and residents were surveyed regarding the new communication system.
Results: Morning sign-out duration decreased from 25.5 to 22.7 minutes (P = 0.0338). All respondents agreed strongly (12/14, 86%) or somewhat (2/14, 14%) that daily morning events reports prevented "loss of key information between shifts" and enhanced safety greatly (10/14, 71%) or moderately (4/14, 29%).All agreed either strongly (10/14, 71%) or somewhat (4/14, 29%) that the daily report improved the quality of handoff information and strongly (12/14, 86%) or somewhat (2/14, 14%) that the report was convenient.
Conclusions: The collection of key clinical handoff information and its automatic forwarding to incoming providers reduced the average duration of resident morning sign-out and significantly enhanced provider perceptions regarding patient safety and the quality of handoff information.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1097/PTS.0b013e31829e4f56 | DOI Listing |
Am J Surg
June 2022
Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH 543, Indianapolis, IN, 46202, USA.
Background: LEAN was developed by Toyota to provide a systematic way to eliminate waste and standardize processes. We sought to introduce LEAN methodology to surgical residents with the goal of increasing rounding efficiency.
Methods: A Kaizen event was used as a rounding efficiency improvement strategy.
Cureus
April 2019
Internal Medicine - Hospital Based Medicine, University of California San Francisco, San Francisco, USA.
Background Current duty hour restrictions have led to increased patient handoffs as well as increased use of faculty in the nocturnist role. Nocturnists typically supervise residents and perform direct patient care leading to a diversity of provider experience level during morning handoffs. In this study, we explored how the presence of nocturnists impacts perceptions patient safety, quality, and educational value of morning care transitions.
View Article and Find Full Text PDFFam Syst Health
December 2018
Faculty of Education.
Introduction: Health professionals and institutions need to understand how to facilitate family involvement within settings designed prior to the adoption of patient- and family-centered philosophies. This study sought to explore how the physical environment of an inpatient rehabilitation setting influenced family involvement in health care delivery.
Method: We conducted this study on the inpatient acquired brain injury ward of a Canadian adult rehabilitation center.
Injury
September 2017
Division of Trauma and Surgical Critical Care, Department of Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI 02903, United States; Division of Surgical Research, Department of Surgery, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI 02903, United States. Electronic address:
Background: The 80h work week has raised concerns that complications may increase due to multiple sign-outs or poor communication. Trauma Surgery manages complex trauma and acute care surgical patients with rapidly changing physiology, clinical demands and a large volume of data that must be communicated to render safe, effective patient care. Trauma Morning Report format may offer the ideal situation to study and teach sign-outs and resident communication.
View Article and Find Full Text PDFVasc Health Risk Manag
September 2017
Division of Cardiology.
Objectives: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program.
Background: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!