1
|
Ryan JM, McHugh F, Simiceva A, Eppich W, Kavanagh DO, McNamara DA. Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes. BJS Open 2024; 8:zrae011. [PMID: 38426257 PMCID: PMC10905088 DOI: 10.1093/bjsopen/zrae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/17/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Poor-quality handovers lead to adverse outcomes for patients; however, there is a lack of evidence to support safe surgical handovers. This systematic review aims to summarize the interventions available to improve end-of-shift surgical handover. A novel taxonomy of interventions and outcomes and a modified quality assessment tool are also described. METHODS Ovid MEDLINE®, PubMed, Embase, and Cochrane databases were searched for articles up to April 2023. Comparative studies describing interventions for daily in-hospital surgical handovers between doctors were included. Studies were grouped according to their interventions and outcomes. RESULTS In total, 6139 citations were retrieved, and 41 studies met the inclusion criteria. The total patient sample sizes in the control and intervention groups were 11 946 and 11 563 patients, respectively. Most studies were pre-/post-intervention cohort studies (92.7%), and most (73.2%) represented level V evidence. The mean quality assessment score was 53.4% (17.1). A taxonomy of handover interventions and outcomes was developed, with interventions including handover tools, process standardization measures, staff education, and the use of mnemonics. More than 25% of studies used a document as the only intervention. Overall, 55 discrete outcomes were assessed in four categories including process (n = 27), staff (n = 14), patient (n = 12) and system-level (n = 2) outcomes. Significant improvements were seen in 51.8%, 78.5%, 58.3% (n = 9761 versus 9312 patients) and 100% of these outcomes, respectively. CONCLUSIONS Most publications demonstrate that good-quality surgical handover improves outcomes and many interventions appear to be effective; however, studies are methodologically heterogeneous. These novel taxonomies and quality assessment tool will help standardize future studies.
Collapse
Affiliation(s)
- Jessica M Ryan
- RCSI SIM Centre for Simulation Education and Research, RCSI, Dublin, Ireland
- StAR MD Programme, School of Postgraduate Studies, RCSI, Dublin, Ireland
- Department of Surgery, The Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - Fiachra McHugh
- Department of Surgery, Mayo University Hospital, Mayo, Ireland
| | - Anastasija Simiceva
- RCSI SIM Centre for Simulation Education and Research, RCSI, Dublin, Ireland
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI, Dublin, Ireland
| | - Dara O Kavanagh
- Department of Surgical Affairs, RCSI, Dublin, Ireland
- Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Deborah A McNamara
- Office of the President, RCSI, Dublin, Ireland
- National Clinical Programme in Surgery, RCSI, Dublin, Ireland
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| |
Collapse
|
2
|
Mahran GSK, Mekkawy MM, Ibrahim BA, Saber EA, Ali M, Abbas MS, Mohamed SAA, Ahmed RD. Designing and Validating an Evidence-Based, Shift-to-Shift Handover Bundle for Nurses and Physicians. Crit Care Nurs Q 2024; 47:41-50. [PMID: 38031307 DOI: 10.1097/cnq.0000000000000490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
This article reports a study aimed at developing and validating an evidence-based, shift-to-shift handover bundle for nurses and physicians to be used at shift changes in intensive care and emergency units. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability can have unwanted consequences for hospitalized patients, particularly those at critical areas. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, standardized handover bundles for nurses and physicians are limited in the emergency and intensive care unit. As a result of this study, a shift-to-shift handover bundle was created, which was an evidence-based research design. This bundle is expected to be helpful for proper patient transfers between these critical areas, ensuring patient safety and efficient quality management.
Collapse
Affiliation(s)
- Ghada Shalaby Khalaf Mahran
- Departments of Critical Care and Emergency Nursing (Drs Mahran and Ali) and Nursing Administration (Dr Saber), Faculty of Nursing, Assiut University, Assiut, Egypt; Department of Medical Surgical Nursing, Al-Galala University, Suez, Egypt (Dr Mekkawy); Department of Medical Surgical Nursing, Minia University, Minia, Egypt (Dr Ibrahim); Departments of Anesthesia and Intensive Care (Dr Abbas) and Chest Diseases and Tuberculosis (Dr Mohamed), Faculty of Medicine, Assiut University, Assiut, Egypt; Sultan Bin Abdulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia (Dr Mohamed); and Department of Critical Care and Emergency Nursing, Faculty of Nursing, South Valley University, Qena, Egypt (Dr Ahmed)
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Wheat CL, Gunnink EJ, Rojas J, Shah A, Nelson KM, Wong ES, Gray KE, Stockdale SE, Rosland AM, Chang ET, Reddy A. Changes in Primary Care Quality Associated With Implementation of the Veterans Health Administration Preventive Health Inventory. JAMA Netw Open 2023; 6:e238525. [PMID: 37067799 PMCID: PMC10111181 DOI: 10.1001/jamanetworkopen.2023.8525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/25/2023] [Indexed: 04/18/2023] Open
Abstract
Importance The COVID-19 pandemic caused significant disruptions in primary care delivery. The Veterans Health Administration (VHA) launched the Preventive Health Inventory (PHI) program-a multicomponent care management intervention, including a clinical dashboard and templated electronic health record note-to support primary care in delivering chronic disease care and preventive care that had been delayed by the pandemic. Objectives To describe patient, clinician, and clinic correlates of PHI use in primary care clinics and to examine associations between PHI adoption and clinical quality measures. Design, Setting, and Participants This quality improvement study used VHA administrative data from February 1, 2021, through February 28, 2022, from a national cohort of 216 VHA primary care clinics that have implemented the PHI. Participants comprised 829 527 veterans enrolled in primary care in clinics with the highest and lowest decile of PHI use as of February 2021. Exposure Templated electronic health record note documenting use of the PHI. Main Outcomes and Measures Diabetes and blood pressure clinical quality measures were the primary outcomes. Interrupted time series models were applied to estimate changes in diabetes and hypertension quality measures associated with PHI implementation. Low vs high PHI use was stratified at the facility level to measure whether systematic differences in uptake were associated with quality. Results A total of 216 primary clinics caring for 829 527 unique veterans (mean [SD] age, 64.1 [16.9] years; 755 158 of 829 527 [91%] were men) formed the study cohort. Use of the PHI varied considerably across clinics. The clinics in the highest decile of PHI use completed a mean (SD) of 32 997.4 (14 019.3) notes in the electronic health record per 100 000 veterans compared with 56.5 (35.3) notes per 100 000 veterans at the clinics in the lowest decile of use (P < .001). Compared with the clinics with the lowest use of the PHI, clinics with the highest use had a larger mean (SD) clinic size (12 072 [7895] patients vs 5713 [5825] patients; P < .001), were more likely to be urban (91% vs 57%; P < .001), and served more non-Hispanic Black veterans (16% vs 5%; P < .001) and Hispanic veterans (14% vs 4%; P < .001). Staffing did not differ meaningfully between high- and low-use clinics (mean [SD] ratio of full-time equivalent staff to clinician, 3.4 [1.2] vs 3.4 [0.8], respectively; P < .001). After PHI implementation, compared with the clinics with the lowest use, those with the highest use had fewer veterans with a hemoglobin A1c greater than 9% or missing (mean [SD], 6577 [3216] per 100 000 veterans at low-use clinics; 9928 [4236] per 100 000 veterans at high-use clinics), more veterans with an annual hemoglobin A1c measurement (mean [SD], 13 181 [5625] per 100 000 veterans at high-use clinics; 8307 [3539] per 100 000 veterans at low-use clinics), and more veterans with adequate blood pressure control (mean [SD], 20 582 [12 201] per 100 000 veterans at high-use clinics; 12 276 [6850] per 100 000 veterans at low-use clinics). Conclusions and Relevance This quality improvement study of the implementation of the VHA PHI suggests that higher use of a multicomponent care management intervention was associated with improved quality-of-care metrics. The study also found significant variation in PHI uptake, with higher uptake associated with clinics with more racial and ethnic diversity and larger, urban clinic sites.
Collapse
Affiliation(s)
- Chelle L. Wheat
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Eric J. Gunnink
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Jorge Rojas
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Ami Shah
- Office of Primary Care, Veterans Health Affairs, Washington, DC
| | - Karin M. Nelson
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington, Seattle
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle
| | - Edwin S. Wong
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Kristen E. Gray
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Susan E. Stockdale
- Department of Psychiatry and Biobehavioral Medicine, David Geffen School of Medicine, University of California at Los Angeles
- Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Ann-Marie Rosland
- Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Health Care System, Pittsburgh, Pennsylvania
| | - Evelyn T. Chang
- Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
- Division of General Internal Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles
- Division of General Internal Medicine, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Ashok Reddy
- Center for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Health Systems and Population Health, University of Washington, Seattle
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle
| |
Collapse
|
4
|
Evaluation of the Situation, Background, Assessment, and Recommendation Handover Tool in Improving Communication and Satisfaction Among Jordanian Nurses Working in Intensive Care Units. Dimens Crit Care Nurs 2021; 39:339-347. [PMID: 33009274 DOI: 10.1097/dcc.0000000000000441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The SBAR (situation, background, assessment, and recommendation) is a standardized handover tool that has been utilized in health care settings. It has positive impacts on staff communication and patient quality of care. In Jordan, few reports are available about handover tools' impacts. PURPOSE To evaluate the implementation of the SBAR among nurses in intensive care units (ICUs) in Jordan. METHODS A pretest-posttest quasi-experimental design was used. A convenience sample of 71 ICU nurses participated. The 43-item ICU physician-nurse questionnaire was used to measure SBAR effectiveness as measured by the following subscales: general relationship and communication, teamwork and leadership, and job satisfaction. RESULTS There was a significant improvement in posttest knowledge scores and in "general relationships and communication" and "satisfaction" scores. There was a significant improvement in both "general relationships and communication" and "satisfaction" posttest scores compared with their pretest scores (t = 16.709, 2.656; P < .001, P < .01) consecutively. CONCLUSIONS This study revealed a strong indicator to encourage the SBAR utilization among nurses in health care settings. The SBAR has a positive impact on enhancing communication between nurses and increasing their job satisfaction. Thus, the utilization of such a standardized tool that maintains and assures good communication relationships shall increase level of satisfaction. Future studies are recommended to provide further evidence on its feasibility and efficacy as compared with traditional handover tools and among different health care contexts.
Collapse
|
5
|
Abstract
INTRODUCTION Verbal handover alone compromises patient safety, and supporting written documents significantly increases retention of information, with printed handover sheets being the best at avoiding data loss. The Royal College of Surgeons (RCS) has produced guidelines on safe handover practice, in which a minimum dataset is recommended for inclusion when handing over patients to incoming surgical teams, and studies have indicated better adherence to these guidelines when preprinted handover proformas are used. METHODS All surgical handover sessions were attended for a one-week period, and copies of handover sheets were taken. These were analyzed against RCS guidelines on the essential dataset for safe handover practice. A standardized handover sheet, developed in accordance with these guidelines and designed to encourage impartation of this minimum dataset, was then circulated among members of the surgical department and made readily available on wards. After a 6-week period, a postintervention audit was conducted using the same methods. RESULTS Striking differences were seen in the quality of information handed over preintervention and postintervention. The documentation of patient location increased significantly (56%-87%, P < 0.0001; 95% CI, 0.460-0.151), as did the documentation of important outstanding clinical tasks (45%-89%, P = 0.004; 95% CI, 0.439-0.089). Documentation of blood results increased (P < 0.0001; 95% CI, 0.523-0.226), and the proportion of patients for whom the occurrence of a senior review was documented increased from 28% (18) to 85% (45) (P < 0.0001; 95% CI, 0.717-0.419) CONCLUSIONS: The use of a structured, computer-generated handover proforma significantly improved compliance with RCS guidelines within the surgical department of our hospital, and we recommend its continued use among on-call surgical teams.
Collapse
|
6
|
Mughal Z, Al-Jazieh I, Zaidi H. Development of a proforma to improve quality of handover of surgical patients at the weekend. J Eval Clin Pract 2019; 25:456-462. [PMID: 30411446 DOI: 10.1111/jep.13063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 10/06/2018] [Accepted: 10/09/2018] [Indexed: 12/01/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The introduction of shift pattern of working in the medical profession has led to an increase in reliance on effective handover of patient information. We evaluated the use of a weekend handover proforma in General Surgical patients at a University Teaching Hospital. METHODS A standardized weekend handover proforma was implemented. A pre-post survey of medical staff and prospective observational study on the use of the proforma was carried out. The impact of three strategies to reinforce change in clinical practice was investigated at random time-points. These were (1) presentation at a clinical governance meeting; (2) email; and (3) induction training on handover combined with one-to-one interactive training. The two outcome measures were compliance with the proforma, and "handover score," which was the amount of data transferred per patient. RESULTS The survey highlighted inadequate provision for handover at the weekend. National guidelines were used to design the weekend handover proforma. There was 70% compliance with the new standardized proforma with a median handover score of 83% (IQR = 0-100). The results were presented at a clinical governance meeting, and the proforma was refined. After this change, the proforma was used in 71% of patients, and the median score was 65% (IQR = 0-80, P = 0.0516). Compliance after an email reminder was 69%, and median handover score was 80% (IQR = 0-90, P = 0.1037). After induction training, there was a significant improvement in proforma compliance (94%) and median score (90%, IQR = 80-90, P = 0.013). CONCLUSION Effective transfer of handover information can be achieved over the weekend with the use of a standardized proforma. Use of the proforma was greatest after providing junior doctors with didactic training on handover combined with interactive guidance on completing the proforma.
Collapse
Affiliation(s)
- Zahir Mughal
- Department of Otorhinolaryngology, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, UK
| | - Iyad Al-Jazieh
- Department of General Surgery, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, UK
| | - Hammad Zaidi
- Department of General Surgery, University Hospital Coventry and Warwickshire NHS Trust, Clifford Bridge Road, CV2 2DX, UK
| |
Collapse
|
7
|
Hogan H, Hutchings A, Wulff J, Carver C, Holdsworth E, Welch J, Harrison D, Black N. Interventions to reduce mortality from in-hospital cardiac arrest: a mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BackgroundUnchecked patient deterioration can lead to in-hospital cardiac arrest (IHCA) and avoidable death. The National Cardiac Arrest Audit (NCAA) has found fourfold variation in IHCA rates and survival between English hospitals. Key to reducing IHCA is both the identification of patients at risk of deterioration and prompt response. A range of targeted interventions have been introduced but implementation varies between hospitals. These differences are likely to contribute to the observed variation between and within hospitals over time.ObjectiveTo determine how interventions aimed at identification and management of deteriorating patients are associated with IHCA rates and outcomes.DesignA mixed-methods study involving a systematic literature review, semistructured interviews with 60 NHS staff, an organisational survey in 171 hospitals and interrupted time series and difference-in-difference analyses (106 hospitals).SettingEnglish hospitals participating in the NCAA audit.ParticipantsNHS staff (approximately 300) and patients (13 million).InterventionsEducation, track-and-trigger systems (TTSs), standardised handover tools and outreach teams.Main outcome measuresIHCA rates, survival and hospital-wide mortality.Data sourcesNCAA, Hospital Episode Statistics, Office for National Statistics Mortality Statistics.MethodsA literature review and qualitative interviews were used to design an organisational survey that determined how interventions have been implemented in practice and across time. Associations between variations in services and IHCA rates and survival were determined using cross-sectional, interrupted time series and difference-in-difference analyses over the index study period (2009/10 to 2014/15).ResultsAcross NCAA hospitals, IHCAs fell by 6.4% per year and survival increased by 5% per year, with hospital mortality decreasing by a similar amount. A national, standard TTS [the National Early Warning Score (NEWS)], introduced in 2012, was adopted by 70% of hospitals by 2015. By 2015, one-third of hospitals had converted from paper-based TTSs to electronic TTSs, and there had been an increase in the number of hospitals with an outreach team and an increase in the number with a team available at all times. The extent of variation in the uses of educational courses and structured handover tools was limited, with 90% of hospitals reporting use of standardised communication tools, such as situation, background, assessment and recommendation, in 2015. Introduction of the NEWS was associated with an additional 8.4% decrease in IHCA rates and, separately, a conversion from paper to electronic TTS use was associated with an additional 7.6% decrease. However, there was no associated change in IHCA survival or hospital mortality. Outreach teams were not associated with a change in IHCA rates, survival or hospital mortality. A sensitivity analysis restricted to ward-based IHCAs did not alter the findings but did identify an association between increased outreach team intensity in 2015 and IHCA survival.LimitationsThe organisational survey was not able to explore all aspects of the interventions and the contextual factors that influenced them. Changes over time were dependent on respondents’ recall.ConclusionsStandardisation of TTSs and introduction of electronic TTSs are associated with a reduction in IHCAs. The apparent lack of impact of outreach teams may reflect their mode of introduction, that their effect is through providing support for implementation of TTS or that the organisation of the response to deterioration is not critical, as long as it is timely. Their role in end-of-life decision-making may account for the observed association with IHCA survival.Future workTo assess the potential impact of outreach teams at hospital level and patient level, and to establish which component of the TTS has the greatest effect on outcomes.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
- Helen Hogan
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Hutchings
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jerome Wulff
- Intensive Care National Audit & Research Centre, London, UK
| | - Catherine Carver
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Holdsworth
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - John Welch
- Critical Care Outreach, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Harrison
- Intensive Care National Audit & Research Centre, London, UK
| | - Nick Black
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
8
|
Nelson P, Bell AJ, Nathanson L, Sanchez LD, Fisher J, Anderson PD. Ethnographic analysis on the use of the electronic medical record for clinical handoff. Intern Emerg Med 2017; 12:1265-1272. [PMID: 27832465 DOI: 10.1007/s11739-016-1567-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/24/2016] [Indexed: 02/07/2023]
Abstract
The objective of this study was to understand the social elements of clinical and organizational interactions of the key stakeholders in the specific context of an electronic dashboard used by the emergency department (ED) and inpatient medicine teams at the time of clinical referral and handover. An electronic handover function is utilised at the ED-inpatient interface at this institution and has given clinicians the ability to better communicate, monitor the department and strive to improve patient safety in streamline the delivery of care in the acute phase. This study uses an ethnographic qualitative research design incorporating semistructured interviews, participant observation on the ED floor and fieldwork notes. The setting for this research was in the ED at a tertiary University affiliated hospital. Triangulation was used to combine information obtained from multiple sources and information from fieldwork and interviews refined into useable chunks culminating in a thematic analysis. Thematic analysis yielded five central themes that reflected how the clinical staff utilised this IT system and why it had become embedded in the culture of clinical referral and handover. Efficient time management for improved patient flow was demonstrated, value added communication (at the interpersonal level), the building trust at the ED-inpatient interface, the maintenance of mutual respect across medical cultures and an overall enhancement of the quality of ED communication (in terms of the information available). A robust electronic handover process, resulted in an integrated approach to patient care by removing barriers to admission for medical inpatients, admitted via ED. The value proposition for patients was a more complete information transfer, both within the ED and between departments.
Collapse
Affiliation(s)
| | - Anthony J Bell
- RBWH Department of Emergency Medicine, Butterfield St, Herston, QLD, 4006, Australia.
| | - Larry Nathanson
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, USA
| | - Jonathan Fisher
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, USA
| | - Philip D Anderson
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, USA
| |
Collapse
|
9
|
Spooner AJ, Aitken LM, Chaboyer W. Barriers and facilitators to the implementation of an evidence-based electronic minimum dataset for nursing team leader handover: A descriptive survey. Aust Crit Care 2017; 31:278-283. [PMID: 29153960 DOI: 10.1016/j.aucc.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/06/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia. An established tool was modified to the intensive care nursing handover context and a survey of all 63 nursing team leaders was undertaken. Survey statements were rated using a 6-point Likert scale with selections from 'strongly disagree' to 'strongly agree', and open-ended questions. Descriptive statistics were used to summarise results. RESULTS AND DISCUSSION A total of 39 team leaders responded to the survey (62%). Team leaders used general intensive care work unit guidelines to inform practice however they were less familiar with the intensive care handover work unit guideline. Barriers to minimum dataset uptake included: a tool that was not user friendly, time consuming and contained too much information. Facilitators to minimum dataset adoption included: a tool that was user friendly, saved time and contained relevant information. Identifying the complexities of a healthcare setting prior to the implementation of an intervention assists researchers and clinicians to integrate new knowledge into healthcare settings. CONCLUSION Barriers and facilitators to knowledge use focused on usability, content and efficiency of the electronic minimum dataset and can be used to inform tailored strategies to optimise team leaders' adoption of a minimum dataset for handover.
Collapse
Affiliation(s)
- Amy J Spooner
- School of Nursing and Midwifery, Griffith University, Nathan, Australia.
| | - Leanne M Aitken
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia; Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Australia; School of Health Sciences, City University London, London, United Kingdom
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| |
Collapse
|
10
|
Rodriguez Torres Y, Huang J, Mihlstin M, Juzych MS, Kromrei H, Hwang FS. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine. PLoS One 2017; 12:e0185052. [PMID: 28934326 PMCID: PMC5608474 DOI: 10.1371/journal.pone.0185052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 09/06/2017] [Indexed: 12/03/2022] Open
Abstract
This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p < 0.0005). Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents’ year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from “mouse click fatigue” as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.
Collapse
Affiliation(s)
- Yasaira Rodriguez Torres
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States of America
- * E-mail:
| | - Jordan Huang
- School of Medicine, Wayne State University, Detroit, Michigan, United States of America
| | - Melanie Mihlstin
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States of America
| | - Mark S. Juzych
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States of America
| | - Heidi Kromrei
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States of America
| | - Frank S. Hwang
- Department of Ophthalmology, Kresge Eye Institute, Detroit, Michigan, United States of America
| |
Collapse
|
11
|
Hogan H, Carver C, Zipfel R, Hutchings A, Welch J, Harrison D, Black N. Effectiveness of ways to improve detection and rescue of deteriorating patients. Br J Hosp Med (Lond) 2017; 78:150-159. [PMID: 28277760 DOI: 10.12968/hmed.2017.78.3.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A number of interventions has been introduced to improve recognition of and response to deterioration, but evidence for improved outcomes is mixed. Future evaluations need better articulation of intervention components and outcomes, longer run-in times and consideration of the interplay between concurrent interventions.
Collapse
Affiliation(s)
- Helen Hogan
- Clinical Senior Lecturer, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH
| | - Catherine Carver
- Clinical Research Fellow, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London
| | - Rebecca Zipfel
- Research Assistant, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London
| | - Andrew Hutchings
- Lecturer in Statistics, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London
| | - John Welch
- Consultant Nurse in Critical Care, University College London Hospital, London
| | - David Harrison
- Senior Statistician, Intensive Care National Audit and Research Centre, London
| | - Nick Black
- Professor of Health Services Research, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London
| |
Collapse
|
12
|
Clinical Information Transfer between EMS Staff and Emergency Medicine Assistants during Handover of Trauma Patients. Prehosp Disaster Med 2017; 32:541-547. [PMID: 28606198 DOI: 10.1017/s1049023x17006562] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Introduction Clinical handover by Emergency Medical Services (EMS) staff, as the first people who have contact with trauma patients, in the emergency department (ED), is very important. Therefore, effective communication to transfer clinical information about patients in a concise, rational, clear, and time-bound manner is essential. In Iran, the transfer of necessary information in clinical handover in EDs was carried out orally and without following standard instructions. This study aimed to audit the current clinical handover according to the Identify, Situation, Background, Assessment, and Recommendation (ISBAR) tool and survey the effect of training the ISBAR tool to Emergency Medicine Assistants (EMAs) and EMS staff on improvement of the clinical handover of patients to the ED. METHODS This is a clinical audit study in three phases in Imam Hossein Hospital (Tehran, Iran) during 2016. In the first phase, the clinical handover between EMS staff and EMAs for 178 trauma patients admitted to the ED using ISBAR was audited and information was recorded. In the second phase, the correct approach of clinical handover according to the ISBAR tool was taught to EMS staff and EMAs using pamphlets and lectures. In the third phase, again, the clinical handover between EMS staff and EMAs for 168 trauma patients admitted to the ED was audited using the ISBAR tool and information was recorded. At the end, clinical audit assessment indicators of handover were evaluated before and after training. RESULTS Clinical audit of the current situation in the ED showed that the clinical handover process does not follow standard ISBAR (0.0%). However, after training, 65.3% of clinical handover processes were performed in accordance with ISBAR. In the current study, there was an increase in all parameters of the ISBAR tool after training, most of which increased significantly compared to the first phase of the study (before the intervention). CONCLUSIONS Findings demonstrate that patient handover in the ED did not initially follow the ISBAR standard guideline. After providing education as pamphlets and lectures to EMS staff and EMAs, a high percentage of patient handovers were conducted in accordance with the ISBAR instructions. Fahim Yegane SA , Shahrami A , Hatamabadi HR , Hosseini-Zijoud SM . Clinical information transfer between EMS staff and Emergency Medicine Assistants during handover of trauma patients. Prehosp Disaster Med. 2017;32(5):541-547.
Collapse
|
13
|
Reducing Patient Clinical Management Errors Using Structured Content and Electronic Nursing Handover. J Nurs Care Qual 2017; 31:245-53. [PMID: 26796972 DOI: 10.1097/ncq.0000000000000167] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined whether an integrated nursing handover system-structured content and an electronic tool within the patient clinical information system with bedside delivery-would improve the quality of information delivered at nursing handover and reduce adverse patient outcomes. Using a pre/posttest evaluative design, improvements in the transfer of critical patient information and reductions in nursing clinical management incidents were demonstrated. No changes in falls or medication incident rates were identified.
Collapse
|
14
|
Spooner AJ, Aitken LM, Corley A, Chaboyer W. Developing a minimum dataset for nursing team leader handover in the intensive care unit: A focus group study. Aust Crit Care 2017; 31:47-52. [PMID: 28238586 DOI: 10.1016/j.aucc.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 12/21/2016] [Accepted: 01/19/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. OBJECTIVES The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. METHODS This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited. Focus groups were conducted using a nominal group technique to generate and prioritise minimum dataset items. Nurses were presented with content from previous team leader handovers and asked to select which content items to include in a minimum dataset. Participant responses were summarised as frequencies and percentages. RESULTS Seventeen senior nurses participated in three focus groups. Participants agreed that ISBAR (Identify-Situation-Background-Assessment-Recommendations) was a useful tool to guide clinical handover. Items recommended to be included in the minimum dataset (≥65% agreement) included Identify (name, age, days in intensive care), Situation (diagnosis, surgical procedure), Background (significant event(s), management of significant event(s)) and Recommendations (patient plan for next shift, tasks to follow up for next shift). Overall, 30 of the 67 (45%) items in the Assessment category were considered important to include in the minimum dataset and focused on relevant observations and treatment within each body system. Other non-ISBAR items considered important to include related to the ICU (admissions to ICU, staffing/skill mix, theatre cases) and patients (infectious status, site of infection, end of life plan). Items were further categorised into those to include in all handovers and those to discuss only when relevant to the patient. CONCLUSIONS The findings suggest a minimum dataset for intensive care nursing team leader shift-to-shift handover should contain items within ISBAR along with unit and patient specific information to maintain continuity of care and patient safety across shift changes.
Collapse
Affiliation(s)
- Amy J Spooner
- The Prince Charles Hospital, Critical Care Research Group, Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia.
| | - Leanne M Aitken
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia; Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Australia; School of Health Sciences, City University London, London, United Kingdom
| | - Amanda Corley
- The Prince Charles Hospital, Critical Care Research Group, Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| |
Collapse
|
15
|
Joyner MK, Afolabi FC, Payne TL, Hueckel RM. Structured Documentation of Home Ventilator Settings in Children: A Quality Improvement Project. J Pediatr Health Care 2017; 31:111-121. [PMID: 27321678 DOI: 10.1016/j.pedhc.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In children requiring long-term mechanical ventilation (LTMV), insufficient admission charting can lead to adverse events. Our purpose in this study was to create and evaluate a structured documentation tool of home LTMV settings to improve communication, documentation, and patient safety. METHOD This study used a pretest-posttest survey of pulmonary unit nurses' satisfaction with the tool and perceptions of patient safety, chart reviews of documentation compliance, and reports of education session attendance. Mann-Whitney U and Fisher exact tests, category analyses, and descriptive statistics were applied. RESULTS Nurses' reports of positive communication of LTMV settings increased from 54.5% to 100% (p = .002), overall satisfaction with associated documentation increased (p < .001), and witnessed related adverse events decreased from 50% to 18.75%. Nurse compliance for education attendance and documentation was 97.4% and 97.3%, respectively. DISCUSSION Structured admission charting of LTMV settings should be continued and yielded improvements in pulmonary unit nurses' perceptions of communication, patient safety, and documentation compliance.
Collapse
|
16
|
Johnson M, Sanchez P, Zheng C. The impact of an integrated nursing handover system on nurses' satisfaction and work practices. J Clin Nurs 2016; 25:257-68. [PMID: 26769213 DOI: 10.1111/jocn.13080] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2015] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES This study examined the impact of an Integrated Nursing Handover System--structured content, a minimum data set and an electronic module within the patient clinical information system--on nurses' satisfaction with handover and changes to practice. BACKGROUND Poor transfer of patient information between clinicians at handover has been associated with adverse patient outcomes. DESIGN A mixed methods pre-post evaluative approach was used. METHODS The Integrated Nursing Handover System was introduced and evaluated within an Australian hospital. Changes to nurses' satisfaction were measured using the modified Bradley Clinical Handover Survey (n = 40 pre, n = 80 post). Three focus groups with clinicians (2) and mangers and educators (1) examined changes to clinical practice. The location of handover was observed. RESULTS Nurses' satisfaction with handover was improved. A two stage approach to handover emerged: nurses received handover of all patients within meeting rooms followed by handover delivered at the bedside. Major categories identified through content analysis included: implementation and the transition, work practice changes and bedside handover, accessible and standardised patient information, accountability for information transfer and a central repository of patient information. CONCLUSION An integrated system has been implemented with positive outcomes of: improved nurse satisfaction with handover, nurses being informed about all patients, enhanced patient transfers and improved patient information for all health professionals. Further research into the potential use of stored patient handover data for research is recommended. RELEVANCE TO CLINICAL PRACTICE This comprehensive system of nursing handover represents the first integrated system of this nature ever reported in the nursing and health literature. This integrated nursing handover system has been successfully implemented resulting in delivery of more comprehensive, logical and standardised patient information at handover.
Collapse
Affiliation(s)
- Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia.,Centre for Applied Nursing Research, South Western Sydney Local Health District, University of Western Sydney (Affiliated with the Ingham Institute, Liverpool, NSW), Sydney, NSW, Australia
| | - Paula Sanchez
- Centre for Applied Nursing Research, South Western Sydney Local Health District, University of Western Sydney (Affiliated with the Ingham Institute, Liverpool, NSW), Sydney, NSW, Australia
| | - Catherine Zheng
- Centre for Applied Nursing Research, South Western Sydney Local Health District, University of Western Sydney (Affiliated with the Ingham Institute, Liverpool, NSW), Sydney, NSW, Australia
| |
Collapse
|
17
|
Jiang SY, Hum RS, Vawdrey D, Mamykina L. In Search of Social Translucence: An Audit Log Analysis of Handoff Documentation Views and Updates. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2015; 2015:669-676. [PMID: 26958202 PMCID: PMC4765635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Communication and information sharing are critical parts of teamwork in the hospital; however, achieving open and fluid communication can be challenging. Finding specific patient information within documentation can be difficult. Recent studies on handoff documentation tools show that resident handoff notes are increasingly used as an alternative information source by non-physician clinicians. Previous findings also show that residents have become aware of this unintended use. This study investigated the alignment of resident note updating patterns and team note viewing patterns based on usage log data of handoff notes. Qualitative interviews with clinicians were used to triangulate findings based on the log analysis. The study found that notes that were frequently updated were viewed significantly more frequently than notes updated less often (p < 2.2 × 10(-16)). Almost 44% of all notes had aligned frequency of views and updates. The considerable percentage (56%) of mismatched note utilization suggests an opportunity for improvement.
Collapse
Affiliation(s)
- Silis Y Jiang
- Department of Biomedical Informatics, Columbia University, New York, NY
| | - R Stanley Hum
- Department of Pediatrics, Columbia University, New York, NY
| | - David Vawdrey
- Department of Biomedical Informatics, Columbia University, New York, NY; NewYork-Presbyterian Hospital Value Institute, New York, NY
| | - Lena Mamykina
- Department of Biomedical Informatics, Columbia University, New York, NY
| |
Collapse
|
18
|
Davis J, Riesenberg LA, Mardis M, Donnelly J, Benningfield B, Youngstrom M, Vetter I. Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review. J Grad Med Educ 2015; 7:174-80. [PMID: 26221430 PMCID: PMC4512785 DOI: 10.4300/jgme-d-14-00205.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 10/15/2014] [Accepted: 12/16/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Multiple organizations have recognized that handoffs are prone to errors, and there has been an increase in the use of electronic health records and computerized tools in health care. OBJECTIVE This systematic review evaluates the current evidence on the effectiveness of electronic solutions used to support shift-to-shift handoffs. METHODS We searched the English-language literature for research studies published between January 1, 2008, and September 19, 2014, using National Library of Medicine PubMed, EBSCO CINAHL, OvidSP All Journals, and ProQuest PsycINFO. Included studies focused on the evaluation of physician shift-to-shift handoffs and an electronic solution designed to support handoffs. We assessed articles using a quality scoring system, conducted a review of barriers and strategies, and categorized study outcomes into self-report, process, and outcome measures. RESULTS Thirty-seven articles met inclusion criteria, including 20 single group pre- and posttest studies; 8 posttest only or cross-sectional studies; 4 nonrandomized controlled trials; 1 cohort study; 1 randomized crossover study; and 3 qualitative studies. Quality scores ranged from 3.5 to 14 of a possible 16. Most articles documented some positive outcomes, with 2 of the 3 studies evaluating patient outcomes yielding statistically significant improvements. The only other study that analyzed patient outcomes showed that interventions other than the electronic tool were responsible for most of the significant improvements. CONCLUSIONS The majority of studies supported using an electronic tool, yet few measured patient outcomes, and numerous studies suffered from methodology issues. Future studies should evaluate patient outcomes, improve study design, assess the role of faculty oversight, and broaden the focus to recognize the role of human factors.
Collapse
|
19
|
Effectiveness of interventions to improve patient handover in surgery: A systematic review. Surgery 2015; 158:85-95. [PMID: 25999255 DOI: 10.1016/j.surg.2015.02.017] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/15/2015] [Accepted: 02/27/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Handover of patient care is a critical process in the transfer of information between clinical teams and clinicians during transitions in patient care. The handover process may take many forms and is often unstructured and unstandardized, potentially resulting in error and the potential for patient harm. The Joint Commission has implicated such errors in up to 80% of sentinel events and has published guidelines (using an acronym termed SHARE) for the development of intervention tools for handover. This study aims to review interventions to improve handovers in surgery and to assess compliance of described methodologies with the guidelines of the Joint Commission for design and implementation of handover improvement tools. METHODS A systematic review was conducted in line with MOOSE guidelines. Electronic databases Medline, EMBASE, and PsyInfo were searched and interventions to improve surgical handover identified. Intervention types, development methods, and outcomes were compared between studies and assessed against SHARE criteria. RESULTS Nineteen studies were included. These studies included paper and computerized checklists, proformas, and/or standardized operating protocols for handover. All reported some degree of improvement in handover. Description of development methods, staff training, and follow-up outcome data was poor. Only a single study was able to demonstrate compliance with all 5 domains guidelines of the of Joint Commission. CONCLUSION Improvements in information transfer may be achieved through checklist- or proforma-based interventions in surgical handover. Although initial data appear promising, future research must be backed by robust study design, relevant outcomes, and clinical implementation strategies to identify the most effective means to improve information transfer and optimize patient outcomes.
Collapse
|
20
|
Anderson J, Malone L, Shanahan K, Manning J. Nursing bedside clinical handover - an integrated review of issues and tools. J Clin Nurs 2014; 24:662-71. [DOI: 10.1111/jocn.12706] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Judith Anderson
- School of Nursing, Midwifery and Indigenous Health; Charles Sturt University; Bathurst NSW Australia
| | - Linda Malone
- Nursing Leadership and Workforce Development; Western NSW LHD; Dubbo NSW Australia
| | - Kerry Shanahan
- Shellharbour and Kiama Hospitals; Shellharbour Square NSW Australia
| | - Jennifer Manning
- School of Nursing, Midwifery and Indigenous Health; Charles Sturt University; Bathurst NSW Australia
| |
Collapse
|
21
|
Johnson M, Sanchez P, Suominen H, Basilakis J, Dawson L, Kelly B, Hanlen L. Comparing nursing handover and documentation: forming one set of patient information. Int Nurs Rev 2013; 61:73-81. [DOI: 10.1111/inr.12072] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Johnson
- School of Nursing & Midwifery; University of Western Sydney; Sydney NSW Australia
- Centre for Applied Nursing Research (a joint facility of the South Western Sydney Local Health District and the University of Western Sydney); Sydney NSW Australia
| | - P. Sanchez
- Centre for Applied Nursing Research; Sydney NSW Australia
| | - H. Suominen
- NICTA; Canberra ACT Australia
- The Australian National University; Canberra ACT Australia
- University of Canberra; Canberra ACT Australia
| | - J. Basilakis
- University of Western Sydney; Sydney NSW Australia
| | - L. Dawson
- University of Wollongong; Wollongong NSW Australia
| | - B. Kelly
- The University of Melbourne; Melbourne Vic. Australia
| | - L. Hanlen
- NICTA; Canberra ACT Australia
- The Australian National University; Canberra ACT Australia
- University of Canberra; Canberra ACT Australia
| |
Collapse
|
22
|
Ibrahim JE, Jeffcott S, Davis MC, Chadwick L. Recognizing junior doctors' potential contribution to patient safety and health care quality improvement. J Health Organ Manag 2013; 27:273-86. [PMID: 23802403 DOI: 10.1108/14777261311321824] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to re-frame perceptions surrounding junior doctors' capacity to contribute to patient safety and quality improvement. DESIGN/METHODOLOGY/APPROACH A targeted literature review was conducted followed by individual telephone interviews and a half-day forum involving junior doctor representatives and selected leaders in the sector. FINDINGS Junior doctors' entry into health care is an ideal time to cultivate practitioners' interest and expertise in improving the health system for better patient care. Junior doctors are more likely to bring or embrace new ideas, and recognize the importance of transparency and integration of technology into healthcare systems. Engaging with junior doctors in collaborative processes, rather than focusing on their more senior colleagues, may create a more effective culture. ORIGINALITY/VALUE The attributes of junior doctors (as they are in the absence of specific quality improvement or leadership training) that are currently underutilized in patient safety and quality improvement are explored, along with the factors limiting and facilitating the utilization of these attributes.
Collapse
|