Evaluation of a Novel Handoff Communication Strategy for Patients Admitted from the Emergency Department
Evaluation of a Novel Handoff Communication Strategy for Patients Admitted from the Emergency Department
Blog Article
Introduction: Miscommunication during inter-unit handoffs between emergency and internal medicine physicians may jeopardize patient safety.Our goal was to evaluate the impact of a structured communication strategy on the quality of admission handoffs.Methods: We conducted a mixed-methods, pre-test/post-test study at a 560-bed academic health center with 60,000 emergency department (ED) patient visits per year.Admission-handoff best practices were integrated into a modified SBAR format, resulting in the Situation, Background, Assessment, Responsibilities & Risk, Discussion & Disposition, Read-back & Record rawafricaonline.com (SBAR-DR) model.
Physician handoff conversations were recorded and transcribed for the 60 days before (n=110) and 60 days after (n=110) introduction of the SBAR-DR strategy.Transcriptions were scored by two blinded physicians using a 16-item scoring instrument.The primary outcome was the composite handoff quality score.We assessed physician perceptions via a post-intervention survey.
Results: The composite quality score improved in the post-intervention cocktail tree for sale phase (7.57 + 2.42 vs.8.
45 + 2.51, p=.0085).Three of the 16 individual scoring elements also improved, including time for questions (70.
6% vs.82.7%, p=.0344) and confirmation of disposition plan (41.
8% vs.62.7%, p=.0019).
The majority of emergency and internal medicine physicians felt that the SBAR-DR model had a positive impact on patient safety and handoff efficiency.Conclusion: Implementation of the SBAR-DR strategy resulted in improved verbal handoff quality.Agreement upon a clear disposition plan was the most improved element, which is of great importance in delineating responsibility of care and streamlining ED throughput.Future efforts should focus on nurturing broader physician buy-in to facilitate institution-wide implementation.