Webster KLW, Keebler JR, Lazzara EH, et al. Jt Comm Qual Patient Saf. 2022;48:343-353.
Effective handoff communication is a key indicator of safe patient care. These authors outline a new model for handoff communication, integrating three theoretical frameworks addressing relevant inputs (i.e., individual organizational, environmental factors), mediators (e.g., communication, leadership), outcomes (e.g., patient, provider, teamwork, and organizational outcomes), and adaptation loops.
Lazzara EH, Simonson RJ, Gisick LM, et al. Ergonomics. 2022;65:1138-1153.
Structured handoffs support appropriate communication between teams or departments when transferring responsibility for care. This meta-analysis aimed to determine if structured, standardized post-operative anesthesia handoffs improved provider, patient, organizational and handoff outcomes. Postoperative outcomes moved in a generally positive direction when compared with non-standardized handoffs. The authors suggest additional research into pre- and intra-operative handoffs is needed.
Abraham J, Meng A, Tripathy S, et al. BMJ Qual Saf. 2021;30:513-524.
Handoffs are essential to communicating important information and preventing adverse outcomes. This systematic review found that bundled interventions commonly used to support handoffs between the operating room and intensive care units included information transfer/communication checklists and protocols. A meta-analysis showed that bundled interventions resulted in significant improvements for a number of clinical and process outcomes, such as time to analgesia dosing, fewer information omissions, and fewer technical errors.
Handoffs are essential to communicating important information and preventing adverse patient care outcomes. This qualitative study explored how information about ICU patients’ family members is included in handovers. Findings suggest that written documentation about the family is inadequate and poorly structured and there is a need for user-friendly handoff tools that include information on patients’ family members.
Herledan C, Baudouin A, Larbre V, et al. Support Care Cancer. 2020;28:3557-3569.
This systematic review synthesizes the evidence from 14 studies on medication reconciliation in cancer patients. While the majority of studies did not include a contemporaneous comparison group, they did report that medication reconciliation led to medication error identification (most frequently drug omissions, additions or dosage errors) in up to 88-95% of patients.
Prior research has found poor communication between hospital-based and primary care physicians and has suggested that this may contribute to medical errors. This systematic review included 19 studies assessing the transfer of information at hospital discharge between hospital-based and primary care providers (PCPs), or evaluating interventions aimed at improving the timeliness and quality of discharge information. The review found that timely communication of discharge summaries was low, with 55% (median) transferred to PCPs within 48 hours and 85% (median) within 4-weeks; 8.5% of discharge summaries were never transferred. Discharge summaries nearly always contained patient demographics, admission/discharge dates and primary diagnoses, but less frequently included pending test results, diagnostic tests performed and discharge medications.
Maxwell J, Bourgoin A, Crandall J. Rockville, MD : Agency for Healthcare Research and Quality; 2020.
Project RED re-engineered discharge with the goal of reducing preventable readmissions. This report summarizes an Agency for Healthcare Research and Quality project to transfer the Project RED experience to the primary care environment. Areas of focus included enhancing the team leader role of primary care physicians in post-discharge care.
Trauma patients are particularly vulnerable to medication errors due to the severity of their injuries and the multiple handoffs and transitions often occurring during their hospital stay. This article reviewed existing medication reconciliation strategies and found that many have poor accuracy, can be costly and time-consuming, and may not be applicable to a trauma population. The authors comment on the urgent need for research supporting safe and efficient medication reconciliation in trauma patients.
Dewar ZE, Yurkonis T, Attia M. Medicine (Baltimore). 2019;98:e17459.
Poor communication and handoffs between providers have been linked to adverse events. The implementation of a standardized hand-off bundle modeled on the I-PASS tool (incorporating illness severity, patient summary, action list, situational awareness, and synthesis by receiver) in an inpatient family medicine service resulted in a significant reduction in medical errors.
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