Summary: Improving Handover Communication

Quality management is essential to the success of the quality improvement of the health care industry. “Management uses management and planning tools to organize the decision making process and create a hierarchy when faced with competing priorities “( Ransom, et al., 2008). Quality measures should have these goals: effective, safe, efficient, patient-centered, equitable, and timely care (Quality Measures, Center for Medicare & Medicaid Services, 2011).

Handoffs during shift change between nurses is one of the most important ways to communicate essential information related to the patients’ care and their safety. This is an evidence-based practice that improves communication among nurses and patients since the handoffs are conducted at the patients’ bedside, face-to-face, with the computer using SBAR. The patients are involved in the update of their care with the incoming nurse, enabling them to share concerns and to add valuable information, which increases patients’ satisfaction. Additionally, during the handoffs, the nurses with the patients are able to review and update the patients’ white board with the goals, activities, procedures, labs, consults, and symptom management for the incoming

Benchmarking for clinical performance measurement involves collecting and reporting data on practices’ clinical processes and outcomes. Measuring clinical performance can create buy-in for improvement work in the practice and enables the practice to track their improvements over time. This information should also be used to identify and prioritize improvement goals and to track progress toward those goals. In addition, these data should be used to monitor maintenance of changes already made ("Module 7. measuring," 2013). Benchmarking can also be utilized to do a comparison between other health care organizations, provide areas where training could improve staff functions.

Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover - an integrated review of issues and tools. Journal Of Clinical Nursing, 24(5/6), 662-671. doi:10.1111/jocn.12706.

It has been proven that bedside handover with ISBAR has provided a safety transition and met patient’s satisfaction that gives more opportunity to clarify information (ACSQHC 2012). Although, bedside handover with ISBAR is strictly implemented, there are difficulties in the application due to ‘changes in complex social practices’ of nurses that somehow limits its uptake (ACSQHC 2012, cited in Jeffcott, Evans & Cameron 2009). This literature review sought to study the rationale as to the effectiveness of bedside handover with ISBAR framework in clinical settings; and to identify the common barriers to effective communication in bedside handover.

Nursing handover is the primary method of sharing patient information between shifts and ensuring continuity of care from shift to shift. Hand over between shifts is a practice that is basic to the organization of the health works and is an essential aspect of health care delivery. Nursing handover at the bedside should be an interactive process, providing opportunities for introducing the staff to the patient as well as for obtaining the patient’s viewpoint. In particular, bedside handover ensures that patients remain at the center of their

Effective communication is crucial aspect of nursing yet too often is placed low on the priority list, especially at shift change. Information related to the care of patients is frequently disseminated at a crowded, noisy nurse station with several nurses rushing to leave and others attempting to get the information necessary to plan care and limit the constant distractions. It is this interaction that allows for information vital patient safety information to be communicated including the acuity of patients.

Missed or ineffective communication can have severe consequences to the life of a patient. A patient’s clinical condition can deteriorate very quickly and the ability to communicate nursing assessment data rapidly and in a way that will be effectively received can

An observational study published in January of 2015 found several barriers to effective communication in handoff reporting. Two prominent barriers were identified; disorganization and the inability to understand the information received. The study determined by incorporating a structured tool for communication, which included categories, aided in ensuring the information’s completeness, as well as improved the level of understanding of the report content (Foster-Hunt, Parush, Ellis, Thomas, & Rashotte, 2015). Halm (2013), identified three key elements incorporated into an effective handoff report. These components included face-to-face or 2-way communication, a structured template or form, and content which allowed the health care worker to hypothesize a diagnosis related to the patients’ clinical condition (Halm, 2013). The four most frequent elements discussed in a handoff report were history, events, patient status, and future care plan (McMullan, Parush, & Momtahan,

Also, there are hardly communication barriers between them. Accordingly, this could be explained that they had a completely handover performance as a result of effective inter-professional communication and collaboration in order to optimise patient’s outcome.

Giving and receiving an incomplete or inadequate patient hand-off could mean the difference between life or death. In 2006, The Joint Commission addressed hand-off communication as a National Patient Safety Goal, and in 2010, the objective became a standard. However, evidence still shows there are gaps and that “substandard or variable hand-offs have contributed to errors, care omissions, treatment delays, inefficiencies from repeated work, inappropriate treatment, adverse events with minor or major harm, increased length of stay, avoidable readmissions, and increased costs” (Halm, 2013). The Joint Commission reported in 2017 that “ineffective hand-off communication was the cause of the majority of medical errors, including sentinel events” ("Inadequate Handoff Communication," 2017). The hospital I selected for my clinic hours uses a communication form that has not been updated in several years. These are the reasons why I chose to update and improve the current hand-off form for my sustainable product to promote better communication and increase patient safety. Furthermore, research proves that “successful hand-off improvement programs have the potential to substantially improve patient safety” ("Inadequate Handoff Communication," 2017).

With the introduction of the SBAR tool, it is critical that leaders as well as all members of the health team demonstrate effective communication skill. As a result of leadership and communication, there are rules and processes according to (ACOG, 2012) there a process for guiding the handoff process includes; interactive communications, limited interruptions, a process for verification and an opportunity to review any relevant historical data. According to (ACOG, 2012), Properly executed hand-offs are interactive and include the opportunity for questions and answers. It continued by saying that every important aspect of the patient's condition and circumstances must be accurately communicated and acknowledged from one party to the other for a safe and effective handoff to occur. Communication at the time of handoff should result in a clear understanding by each team member. Patient handoff report and clinical communication can be improved to promote high quality medical and nursing care. Hand off reports are the most common type of communication between nurses. Ineffective hand offs can have negative consequences on a client's health. There can be delay in care if the information received is not clear and concise. The wrong type of treatment and a risk for inadequate care may also occur. Effective and efficient communication during hand offs in the clinical setting not only increased client satisfaction and outcomes, but created an environment that promoted staff fulfillment as well. A nurse’s primary concern is the safety of patients. Effective communication is a necessary tool in minimizing client harm and maximizing quality of

Barrier to handoff communication is the number of individuals involved in patient care according to a study conducted a surgical patient sees an average of 26 health providers during their hospital stay. As patient transits each complex phase of care in an operating room each team of care givers with different types of responsibilities and objectives it is very important to deliver effective communication among health providers to reduce adverse

Health care is in a constant state of change. Health care organizations must recognize that change is needed to improve the quality and safety of patient care, retain employees, and restructure the organizational chart to maintain their viability. When changes are carefully and deliberately thought through using the knowledge and skill of leaders, this is considered planned change. The change agent plays a major role in the outcome of the change; whether the change is successful or unsuccessful (Marquis & Huston, 2012). The purpose of this paper is to identify a deficiency within a department of a healthcare organization. A description of the planned change to address the deficiency will be

Adams, J. M. and Osborne-McKenzie, T. (2012). Advancing the evidence base for a standardized provider handover structure: Using staff nurse descriptions of information needed to deliver competent care. Journal of Continuing Education in Nursing, 43(6), 261-266.