Improving communication via electronic handoff in the ICU

Purpose of Project: In an ICU environment, precise, high-quality communication between all disciplines for well-coordinated care of the ICU patient is imperative. The purpose of this quality improvement project is to increase utilization of an e-handoff tool during transitions of care within the ICU. Methodology: A prospective observational study of shift handovers at 7am, 11am, and 7pm were assessed for e-handoff compliance. Direct observations were used to explore shift handover communication, and process, in relation to e-handoff compliance; Study interventions included collecting baseline compliance data through a web-based anonymous survey and collecting post-compliance data through direct observations of the handoff process. Results: A total of 41 participants completed the pre-intervention anonymous survey; 3 survey entries were omitted due to missing/incomplete data. The remaining 38 surveys were used for data analysis to calculate baseline compliance rates. Compliance rate was calculated as: Compliance rate=((total-noncompliances)÷total)×100. Baseline data gathered from the survey indicated that zero registered nurses used the e-handoff tool; pre-compliance rate was 0% (n=0). Post-intervention: 50 individual patient handovers were observed to see if staff incorporated the e-handoff tool into their handoff process. Post-intervention data showed that 12 registered nurses used the e-handoff tool; post-compliance rate was 24% (n=12). Results show a total increase in compliance rates of 24% which indicated a positive correlation between e-handoff education and e-handoff tool usage. Implications for Practice: The evolution of current handoff practices to include electronic handoff can support safety initiatives set forth by the regulatory agencies to improve staff communication. A consistent and structured approach to handoff communications provided from an EMR-based e-handoff tool could help maintain information and patient-management continuity between providers. Also, being able to provide handoff content in “real time” can decrease the chances for communication-related patient care errors.D.N.P.Includes bibliographical reference