Behind Closed Doors: It Was Just Like the Brochure!
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By: Pegi Wasserman
Published: 10/6/2015
Patient handoffs are those critical times when you communicate essential patient information and transfer responsibility of care. They're also opportunity for errors when nurses are distracted, hurried or interrupted. Listen in during handoffs at your facility to ensure they're concise, accurate and valuable. If they're not, reinforce the importance of incorporating these elements in every patient handoff.
Review and reinforce
Your staff can have every good intention of making every effort to perform concise, accurate and valuable handoffs, but in the day-to-day busyness and complexity of the perioperative setting, it's too easy to lose track of the patient at the center of all of the activity. Inattention, distractions and interruptions can easily derail the handoff (see "Avoid These Communication Pitfalls").
Poor handoffs are vulnerable junctures where errors can occur. When mistakes do happen, they start a cascade of unwanted events, ranging from minor incidents to serious safety events. For example, the failure to anticipate the need for particular supplies due to an inadequate handoff may seem like a minor hiccup, but if you look more closely at the unintended consequences of the mistake, you'll notice that it can extend anesthesia time, cause cases to last longer than they should and, subsequently, frustrate surgeons and negatively impact the surgical team's performance.
We recently faced handoff issues at our hospital. There wasn't a standard protocol across perioperative services, and recent staff changes mixed nurses with various experiences, which caused confusion about communication expectations during patient exchanges. We were performing handoffs, but not very well. We also heard these comments from the nurses and anesthesia providers involved in handoffs:
If you sense your staff's focus on handoffs is slipping, take a few minutes to reinforce the importance of clean exchanges. Role-play proper interactions at your next staff meeting, so staff see and hear what you expect to occur when patients move from one clinical area to another. Good handoffs lead to a nearly seamless transition of care that dramatically improves patient safety.
HANDOFF HANG-UPS
Avoid These Communication Pitfalls
We had to address a few communication issues that occurred during patient handoffs at our hospital. Perhaps you've seen them occur in your facility, too.
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