Standard handoff practices help children's hospitals cut errors

Hospitals can cut handoff-related errors nearly 70 percent by standardizing care transfers during shift changes, according to a study published ahead of print in the journal Pediatrics.

For the study, 23 children's hospitals joined a quality improvement collaborative with the goal of cutting care failures tied to handoffs. Participating hospitals used evidence-based recommendations for handoff content and intent, standardized handoff techniques and clear-cut responsibility transitions, according to the study.

Researchers, led by Michael T. Bigham, M.D., of Akron Children's Hospital, analyzed the 7,864 handoffs performed over the year-long study period and found handoff-related care failures decreased from a baseline of 25.8 percent to 7.9 percent, with substantial improvement in every type analyzed.

"Ultimately, what we want is fewer kids to be harmed," Bigham told the Associated Press. "We know bad handoffs harm patients. We want those kids to be safer."

The type of handoff analyzed varied by hospital; for example, at Akron Children's, the initiative focused on shift changes. Hospitals participating in the initiative established standards to make sure each care transition involved sharing vital patient information, such as weight, allergies and guardianship status.

Some units had existing, but flawed, methods for handoff transitions, Bigham told the AP, such as recorded messages by the outgoing nursing coordinator so that incoming nurses could hear any updates. "With that, there would be no opportunity to ask any clarifying questions," he said. "The parents wouldn't really be able to be logically introduced with their nurse at the change of shift. There weren't any safety checks." That's why outgoing and incoming nurses now make sure to meet face-to-face in patient rooms during shift changes to go over vital information.

Multiple studies have found standardizing handoff communication cuts medical errors, which are often due to miscommunication between providers, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the AP article

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