Web tools may improve communication during handoffs, reduce medical errors

care team

Web-based communication tools during patient handoffs can reduce medical errors, according to research published in JAMA Internal Medicine.

Researchers analysed the impact of a web tool that scans electronic patient records to provide clinicians with key information during handoffs. The study team interviewed clinical staff at Brigham and Women’s Hospital in Boston who worked on two shifts--“nightfloat” (between midnight and 7 a.m.) and “twilight” (4 p.m. to midnight)--checking for errors and determining which may have been avoidable.

The team began the survey in 2012, before the web tools were offered, comparing the number of errors during that period to the number after the tools were implemented in 2013. According to the research letter, the team recorded 77 errors during examined handoffs between November 2012 and February 2013, with just 45 noted the following year after clinicians began using the digital tools. All told, the survey examined more than 5,000 patient cases.

The handoff is a time that is particularly risky for patients if the care team is not adequately informed, FierceHealthcare has previously reported, and measures to improve communication during such periods have significantly reduced preventable errors.

The tool used by Brigham and Women’s Hospital was built in-house, so it’s not available to other facilities, but hospitals can take strategies away from what worked for Brigham, said Robert Wachter, M.D., interim chair at the University of California San Francisco’s Department of Medicine, in a commentary published in JAMA Internal Medicine alongside the research.

“As hospital care is increasingly shift-based, a clear and efficient handoff process is vital,” the commentary reads. “The study … shows how web-based handoff tools may improve hospital workflow and patient safety, but only if they are carefully built and integrated into existing systems.”

Brigham also found success in its program because it combined new technologies with training to ensure staff members could actually use the web-based tools, Stephanie Mueller, M.D., the study’s lead author and an associate physician in primary care and general internal medicine at Brigham, told Kaiser Health News. This is a key step for any hospital that plans to implement new technologies, she said.

“You’re not going to throw a tool in someone’s lap and say, ‘Here. Use this, and good luck,’” Mueller told KHN.

- here’s the study
- read the commentary
- check out the KHN article