In late 2007, staff members at Abington (PA) Memorial Hospital (AMH) knew their handoff process could use some work.
Their process, like that of many other hospitals, used a paper form to communicate important patient information from one provider to the next. However, the form would often be filled out improperly, labels would be missing, and ultimately, the receiver might not be aware of everything he or she needed to know about a patient, putting the patient at risk for an error in care.
The hospital also needed to stay in compliance with the National Patient Safety Goal concerning handoff communication, currently NPSG.02.05.01. Additionally, nurses often had to double-document information on the handoffs that had already been captured in the electronic medical record.
AMH had implemented computer physician order entry and clinical documentation by September 2007 and decided to utilize the EMR to enhance its handoff process. At the time, the hospital also used another system that pulled information from the EMR to provide patients with a daily care report.
"We thought maybe we could use that type of technology—that report writing—to get better, more accurate information in a simple way to ancillary staff," says Diane Humbrecht, MSN, RN, C, nurse director of informatics at AMH.
Humbrecht and her colleague Linda Mimm, RN, BC, DL, CPHQ, safety and quality specialist at AMH's Center for Patient Safety & Quality, worked with a team to decide how the process would function and what information should appear on the new "electronic hall pass."
The team decided that the information contained on the handoff should be pulled directly from the EMR, using the documentation notes that the nurse wrote up each morning. However, only data deemed pertinent would be included, as the team wanted to limit the printout to one page. This included items such as whether the patient was a fall risk, whether the patient was on oxygen, and the patient's isolation and code statuses. Since the effort launched, a team of support staff members reviews this list of items regularly to ensure that they are the most important ones to include.