Journal article
Developing Standardized "Receiver-Driven" Handoffs Between Referring Providers and the Emergency Department: Results of a Multidisciplinary Needs Assessment
Joint Commission journal on quality and patient safety, v 44(12), pp 719-730
01 Dec 2018
PMID: 30122519
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Miscommunication during patient transfers is a leading cause of medical errors. Inpatient standardization of handoff communication has been associated with reduced medical errors, but less is known about best practices for handoffs from referring providers to the emergency department (ED). The study aims were to identify (1) stakeholder perceptions of current handoff processes and (2) key handoff elements and strategies to optimize patient care on transfer.
Methods: A mixed-methods needs assessment study was conducted at a tertiary care children's hospital with a communi-cation center that receives verbal handoff via telephone from referring providers and provides written summary to the ED. ED, primary care providers, and communication center staff were surveyed to understand perceptions of handoff processes and ideal handoff elements. Focus groups were conducted to refine concepts. Descriptive statistics, chi-square analysis, and qualitative content analysis were used to analyze responses.
Results: The survey response rate was 129/152 providers (85%). Forty-two percent of respondents described the quality of the handoff process as "very good" or "excellent"; 43% reported miscommunication occurring "sometimes" or "frequently." Within the I-PASS framework-Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver-respondents identified 10 key elements to obtain through a receiver-driven process to optimize care on transfer. Free-text responses revealed a perceived need to standardize communication.
Conclusion: A minority of providers perceived handoff quality between outpatient practices and the ED as "very good" or "excellent"; almost half perceived regular miscommunication. A receiver-driven process is a novel approach that may help ensure standardized communication of key handoff elements in this context.
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Details
- Title
- Developing Standardized "Receiver-Driven" Handoffs Between Referring Providers and the Emergency Department: Results of a Multidisciplinary Needs Assessment
- Creators
- Kathleen Huth - Boston Childrens Hosp, Complex Care Serv, Div Gen Pediat, Boston, MA 02115 USAAnne M. Stack - College Station Medical CenterGrace Chi - College Station Medical CenterRobert Shields - Boston Childrens Hosp, Crit Care Transport Program, Boston, MA USAMaria Jorina - Boston Childrens Hosp, Ctr Appl Pediat Qual Analyt, Boston, MA USADaniel C. West - Univ Calif San Diego, Dept Pediat, San Diego, CA 92103 USAChristopher P. Landrigan - College Station Medical CenterNancy D. Spector - Drexel Univ, Coll Med, Fac Dev, Philadelphia, PA USAAmy J. Starmer - College Station Medical Center
- Publication Details
- Joint Commission journal on quality and patient safety, v 44(12), pp 719-730
- Publisher
- Elsevier
- Number of pages
- 12
- Grant note
- Program for Patient Safety & Quality, Boston Children's Hospital
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000450681300004
- Scopus ID
- 2-s2.0-85051624336
- Other Identifier
- 991019335241304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services