Handoff Communication Tool Improves Patient Safety

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Abstract

Medical errors account for a significant number of medical injuries and deaths in America. It is estimated that miscommunication during the care transfer between the care providers result to over eighty percent of the reported serious medical and clinical errors. Health care provider struggle to with the handed-off communication in the process of transferring the patient. In many instances, critical and necessary information concern the patient being handed-off are not effectively passed on to the new team of care givers, hence limiting effective care provision and increasing medical errors. However, a publication by the Journal of the American Medical Association asserts that medical errors can substantially be reduced without any burden to the existing workflow through standardization of the verbal and written communication during handoff process. This research focuses on the PICO based guidelines to demonstrate the medical errors that patients under surgical procedures are exposed to. The research further addresses the effectiveness of improved handoff communication in reducing possible medical errors that might occur in the transition process, hence, improved patient’s safety.

HANDOFF COMMUNICATION TOOLS IMPROVE PATIENT SAFETY

Most doctors and nurses start their careers with the expectation of gaining the needed professional skills and knowledge primarily to improve the quality of healthcare by providing high-quality healthcare services. In the process of their practise, they come to realize that providing healthcare is more complex exercise that is characterized by bureaucracies, thus limiting their ability and capacity to provide the desired quality healthcare (Pubmed, 2013). The patients’ safety is at the mercy of the health care providers. The patients are subjected to different degrees of care and risks that are associated with healthcare. Therefore, patients seeking medical attention are likely to suffer from simple medical errors, with those undergoing medical surgeries being the victims of many medical errors. Since surgical patients are anesthetized, they have limited control or influence on their medical procedures and processes, therefore, making them more vulnerable to surgical errors. In the process of surgery and care provision, the patients suffer from errors committed by the professionals whom they have entrusted with the responsibility of providing safe and quality care. The major source of such surgical errors is the miscommunication between the care providers during the handoff exercise (Garber, Gross & Slonim, 2010).

There have been cases where patients have had surgery and foreign objects like gauze and scalpels left in the patient’s body after the completion of the surgery. In addition, pathology specimen mislabelling, transfusion drugs prescription errors, and administering of incorrect quantity of drugs have been reported as the leading forms of medical and clinical errors. All these errors are attributed to communication breakdown between the care providers, especially during the transitions and handoffs (Lobdell & Stamou, 2013). These are errors that are preventable if a smooth and effective handoff communication is facilitated. Therefore, addressing this problem calls for tightenig all the possible communication loopholes that may occur in the handoff process. Effective handoff communication process is fundamental to enhancing the quality of healthcare and increase patient’s safety.

Improved handoff communication is beneficial to all the parties to healthcare; from the patient, nurse, and the doctor. Therefore, healthcare providers should strive to improve the quality of healthcare through effective communication during the handoff process. In the case of surgical patients, like the rest of healthcare, there is a positive relationship and correlation between communication and the safety of the patients (Wachter, 2012). Ineffective communication by the healthcare providers during the patients handover process increases the chances of medical and clinical errors that potentially causes tension among the health providers, resource wastage, and loss of valuable persons through medical error related deaths.

To avert these problems that arise from miscommunication in the handover process, we must improve on communication in the surgical procedure. For example, if a briefing is done before the surgical procedure is done, the team leader is established, all those involved be it the surgery, nurses, surgeons, student doctors are informed on what is required of them. Unlike, the usual pecking orders where this hardly happens (Garber, Gross & Slonim, 2010). For example, in a case where a patient who has been in a road accident and requires surgery also has a severe hip sprain. However, the sender health care worker forgets to mention this fact and no one know it other health care worker down the line will repeatedly further distort the patient’s hip causing distress and worsening the patient’s injury. When there are a big number of sender health care providers to give information about the same patient, there is a possibility of passing mixed information to the receiver. From the multiple sources and interpreting this takes time than when everyone has a specific issue to address ( Pubmed 2011).

The essence is to know what they are supposed to do and when. They should know how to handle any potential emergency if it should ever happen. The perceived safety issues should be addressed should they arise (Garber, Gross & Slonim, 2010). They should be able to review the procedure together. The instrumentation for use should be counterchecked, the drugs to be used, and everything that requires clarification should be dealt with at this point. It is better because the tension associated with surgery has not built up. When a patient is brought to the hospital, the expectation of the Receiving health care attendant is to get the critical information needed for them to safely care for the patient. The Sender, on the other hand aims to communicate the patient’s critical information to the receiving health care worker (Wachter, 2012). Many a times there is a disconnect between the critical information the Receiver gets. Some other information may not be necessary.

Receiving health caregivers have often gotten incomplete handoffs than Sender health care providers give. Sometimes there is a lack of teamwork, ineffective communication, inadequate amount of time during the hand off period, the sender healthcare providers may have very little information on the patient, and the receiver may have other competing priorities for his attention. Even at times the receiving health care worker may be unresponsive (Garber, Gross & Slonim, 2010). Solutions should include, to foster teamwork that will enhance communication. There should be adequate time allowed for a successful handoff procedure. Educate all health care providers on what is a standard handoff procedure and make it a priority in handling patients (Pubmed 2011). Engage staff in actual situations to test their hands off skills. Healthcare Senders should be encouraged to uses standardized forms during handoff. Inculcate the use of new technologies to assist in making the handoff successful and complete, for example, personal data assistants that would be recording information real time and electronic medical records (Garber, Gross & Slonim, 2010). It would cut on the time it takes to do the handoff and the incidents of data loss would be minimized health care Sender should identify and stresses key information to be relayed to the receiving health care worker.

A successful patient handover will have a direct impact on reducing morbidity and mortality rate among healthcare seekers (Lobdell & Stamou, 2013). The handing over of the patients to from the clinical to the theatre team should following the laid down changeover procedures and handoff. This is critical since there no competing interests at this time between the cares providers. Therefore, the handoff process must be smooth and efficient with all the necessary documents and information regarding the patient’s medical needs to be adequately addressed between the transitional medical parties, otherwise, more patients will succumb to medical and clinical miscommunication and errors.

References

Does improving handoffs reduce medical error rates?. PUBMED. 2014, March 30, http://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed&querykey=5.

Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Lobdell, K. W., & Stamou, S. C. (2013). Quality improvement: Methods, principles and role in healthcare. New York: Nova Science Publishers. Alexander, E. L.

Nurses’ experiences and perspectives on medication safety practices: an explorative qualitative study. PUBMED. 2014, March 30, HYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/24635029” http://www.ncbi.nlm.nih.gov/pubmed/24635029.

Wachter, R. M. (2012). Understanding patient safety. New York: McGraw-Hill.