Healthcare News & Insights

EHR tool improved handoffs during shift changes

When shifts change for the day, detailed handoff conversations are essential to keeping patients safe and stable during the transition. They’re also helpful with avoiding errors and adverse events. Taking advantage of available health IT can make handoffs more streamlined, reducing the likelihood that important medical information will fall through the cracks. 

Research published in JAMA Internal MedicineTwo doctors looking at computer screen shows the impact of one web tool that was integrated with a hospital’s electronic health records (EHR) system.

According to an article from Kaiser Health News, the tool scans patients’ medical records to look for the key details doctors would need to know during a shift change, including demographic information and patient allergies, along with any progress notes.

It then compiles that information and displays it separately so it stands out easily. That way, the next shift of clinical staff members can see what’s important at a glance.

Fewer errors

The JAMA Internal Medicine study examined whether the new tool helped residents at Brigham and Women’s Hospital avoid medical errors after shift changes, specifically for the “nightfloat” shift from midnight to 7 a.m. and the “twilight” shift from 4 p.m. to midnight.

Researchers compared survey data from residents regarding over 5,000 patient cases both before and after the implementation of the new tool.

Improvement was significant after they were trained on using the tool for handoffs. The new tool helped residents cut medical mistakes in half during the year immediately following its implementation.

Along with the tool, clinical staff at Brigham and Women’s were also trained on better communication skills to improve handoff conversations. Topics covered included the best ways to talk with other health professionals and how to properly convey the electronic health information about each patient.

Best tactic for handoffs

Using an approach that combines boosting verbal communication skills and automating information transfer through technology may be the best strategy to reduce the risks that arise during shift changes.

In a commentary letter about the study (also published in JAMA Internal Medicine), doctors Adam Schoenfeld and Robert Wachter discuss how other facilities can have similar success with reducing medical errors after handoffs.

While not all hospitals can use the same tools in their EHRs (since many systems are different), general features such as auto-populating certain forms with pertinent information about patients’ treatment can increase efficiency and improve communication during handoffs.

Whatever strategy a hospital uses to improve handoffs during shift changes, it should make communication simple, without too much extra burden on providers and clinical staff.

Using techniques such as I-PASS (which is a mnemonic for illness severity, patient summary, action list, situation awareness/contingency plans, and synthesis by receiver) keeps these conversations brief and informative. Adding in automation via an EHR tool can leave even less room for error.

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