Advertisement

 

 

Assessing the implementation of a bedside service handoff on an academic hospitalist service.

Assessing the implementation of a bedside service handoff on an academic hospitalist service.
Author Information (click to view)

Wray CM, Arora VM, Hedeker D, Meltzer DO,


Wray CM, Arora VM, Hedeker D, Meltzer DO, (click to view)

Wray CM, Arora VM, Hedeker D, Meltzer DO,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Healthcare (Amsterdam, Netherlands) 2017 07 05() pii S2213-0764(16)30207-X
Abstract
BACKGROUND
Inpatient service handoffs are a vulnerable transition during a patients’ hospitalization. We hypothesized that performing the service handoff at the patients’ bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care.

METHODS
We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service. On a weekly basis, transitioning hospitalists co-rounded at patient’s bedsides. Post-handoff surveys assessed for completeness of handoff, communication, missed information, and adverse events. A control group who performed the handoff via email, phone or face-to-face was also surveyed. Chi-square and item-response theory (IRT) analysis assessed for differences between BHO and control groups. Narrative responses were elicited to qualitatively describe the BHO.

RESULTS
In total, 21/31 (67%) scheduled BHOs were performed. On average, 4 out of 6 eligible patients experienced a BHO, with a total of 90 patients experiencing a BHO. Of those asked to perform the BHO, 52% stated the service transition took 31-60min compared to 24% in the control group. Controlling for the nesting of observations within physicians, IRT analysis found that BHO respondents had statistically significant greater odds of: reporting increased patient awareness of the service handoff, more certainty in the plan for each patient, less discovery of missed information, and less time needed to learn about the patient on the first day compared to control methods. Narrative responses described a more patient-centered handoff with improved communication that was time-consuming and often logistically difficult to implement.

CONCLUSIONS
Despite its time-intensive nature, performing the service handoff at the patient’s bedside may lead to a more complete and efficient service transition.

Submit a Comment

Your email address will not be published. Required fields are marked *

16 − six =

[ HIDE/SHOW ]