How to Improve Handoff Communication for Better Patient Care
In the realm of healthcare communications, there is no more delicate interface than the handoff of information at the end of each nursing shift or the relocation of a patient from one department to another. Typically, it requires a series of protocols to transfer essential information and the responsibility for care of the patient from one health care provider to another. Handoffs can be complex interactions and pose considerable patient risk.
A recent report in the Medical Press cited a US Veteran Affairs study that interviewed experts from the Regenstrief Institute, the Department of Veterans Affairs, the Indiana University School of Nursing and Wayne State University School of Medicine and Applied Decision Science. It notes, “The transition of care from one doctor to another has been associated with delays in diagnosis and treatment, duplication of tests or treatment and patient discomfort, inappropriate care, medication errors and longer hospital stays with more laboratory testing,” states the report. “Handoff education varies widely in medical schools and residency training programs. There have been efforts to improve transfers of care, but they have not shown meaningful improvement.”
Understanding the potential seriousness of the problem, the American College of Obstetricians and Gynecologists (ACOG) Committee on Patient Safety and Quality Improvement published an opinion seeking to fine-tune patient handoffs, stating,
“Properly executed handoffs are interactive and include the opportunity for questions and answers. Every important aspect of the patient’s condition and circumstance 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 the handoff should result in a clear understanding by each clinician about who is responsible for which aspects of the patient’s care. “
With the logistical challenges of modern healthcare, handoffs no longer always happen face-to-face in real time. The sharing of digital files and electronic information between team members is often required outside of shift schedules, when problems arise or a patient is transferred to a new department or facility. Fortunately communications tools have been developed that may help keep such exchanges secure, comprehensive and, perhaps most importantly, interactive.
Ease of use is also a consideration and one reason that mobile technology is getting set to change the way healthcare professionals share patient information during handoffs and in other high stakes scenarios. Mobile devices already dominate social and professional day-to-day communications. Developing healthcare specific apps such as PageMe, a secure, encrypted communication platform for a closed network of colleagues that works on any smartphone, harnesses that existing ubiquity and power. Handoffs can happen at any time, securely. And with the capacity to include charts, test results, illustrations, patient histories and other specific information, innovative products like PageMe offer healthcare teams the opportunity to share the most comprehensive patient dossiers possible.
Can cloud-based tools and communications aids improve the quality of medical handoffs? If they can provide benchmarks, prompts and acknowledgements for the most complete, clear and up to date exchange of information possible, the answer is a resounding yes.