SALT LAKE CITY, UT (12/7/2010) – LDS Hospital is part of an elite group of hospitals working to improve one critical part of the American healthcare system: communications between caregivers.
LDS Hospital has joined with nine other organizations — including the Mayo Clinic, Johns Hopkins, Massachusetts General, and Stanford University Hospital & Clinics — to participate in a Joint Commission project to improve communications whenever a patient transitions from the care of one person, unit, or hospital to another, in what is known as a “handoff.”
Five of the 10 hospitals — including LDS Hospital — are piloting handoff solutions and have reduced the number of communication problems by more than 50 percent, according to the Joint Commission, the organization that accredits and certifies more than 18,000 healthcare organizations and programs in the United States.
Patient handoffs happen all the time in a hospital — when a patient moves from the emergency department to an inpatient unit, when nurses or physicians change shifts, or when a patient is discharged to go home or to another facility. One study estimated that the typical teaching hospital has 4,000 patient handoffs every day, or 1.6 million per year.
"Think about those staggering numbers, and think about how many opportunities there are for miscommunication. Even a very high percentage of success is not good enough," said Mark R. Chassin, MD, the commission's president.
The result can be errors, delayed treatment, or longer hospital stays.
The Hand-off Communications Project began in August 2009, when the 10 hospitals began studying handoffs. “Senders” — the individuals handing off responsibility for a patient — reported that they were dissatisfied with handoff communications for some reason 21 percent of the time. “Receivers” were dissatisfied 37 percent of the time.
After that analysis, project members came up with several ideas for improving handoff communications, including:
- Standardizing forms and routines to ensure key details are always communicated.
- Allowing all parties to ask questions, and providing contact information in case new questions arise.
- Monitoring communication tools to ensure they’re being used accurately and at the right time.
Nurses at LDS Hospital developed their own standardized form, which eventually may be rolled out for wider use by other Intermountain Healthcare hospitals.
“The biggest challenge was changing the way nurses do reporting,” says Patricia Konen, a nursing educator who is helping to oversee the pilot project at LDS Hospital. “In the past, nurses had their own ways of handling shift-change reporting. Now we use a handoff tool and everyone is on the same page and doing their reports in the same way. Many of them say they wouldn’t go back.”
“Our caregivers say they are seeing faster, smoother and more thorough handoffs since we began using the standardized forms,” said Mikelle Moore, administrator of LDS Hospital. "We’re excited to be at the forefront of this effort. This is the kind of work that can improve the care patients receive all across the country.”
The Joint Commission will make handoff communication strategies available for use by other hospitals in 2011. The Joint Commission will also provide step-by-step suggestions for implementing the changes, tools for measuring performance, and ideas for identifying barriers and customizing the program for individual hospitals.
In addition to LDS Hospital, the other participants included Exempla Lutheran Medical Center in Colorado; Fairview Health Services in Minneapolis; The Johns Hopkins Hospital, Baltimore; Kaiser Permanente Sunnyside Medical Center, Clackamas, OR; Mayo Clinic Saint Mary’s Hospital in Rochester, MN; New York-Presbyterian Hospital, NY; North Shore-LIJ Health System Steven and Alexandra Cohen Children’s Medical Center, New Hyde Park, NY; Partners HealthCare, Massachusetts General Hospital, Boston; Stanford Hospital & Clinics, Palo Alto, CA.