TY - JOUR
T1 - Ensuring effective care transition communication
T2 - Implementation of an electronic medical record–based tool for improved cancer treatment handoffs between clinic and infusion nurses
AU - Pandya, Chintan
AU - Clarke, Tammy
AU - Scarsella, Elizabeth
AU - Alongi, Alex
AU - Amport, Stephanie Buia
AU - Hamel, Lauren
AU - Dougherty, David
N1 - Publisher Copyright:
© 2019 by American Society of Clinical Oncology
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - PURPOSE Ineffective handoffs contribute to gaps in patient care and medication errors, which jeopardize patient safety and lead to poor-quality care. The project aims are to develop and implement a standardized handoff process using an electronic medical record (EMR)–based tool to ensure optimal communication of treatment-related information for patients receiving cancer treatment between oncology nurses. METHODS A multidisciplinary team convened to develop a standard and safe treatment handoff process. The intervention was developed over a series of phases using Plan-Do-Study-Act methodology, including current workflow process mapping; identifying gaps, limitations, and potential causes of ineffective handoffs; and prioritizing these using a Pareto chart. An EMR-based tool incorporating a standardized treatment handoff process was developed. Study outcomes included proportion of handoff-related medication errors, tool utilization, handoff completion, patient waiting time, and nurse satisfaction with tool. All outcomes were evaluated before and after the intervention over a 1-year period. RESULTS The proportion of medication errors as a result of ineffective handoffs was reduced from 10 of 17 (60%) pre-intervention to 11 of 34 (32%) postintervention (P = .07). The EMR-based handoff tool was used in 9,274 of 10,910 (85%) patient treatment visits, and the handoff completion rate increased from 32% pre-intervention to 86% postintervention. Patient waiting time showed an average reduction of 2 minutes/patient/month. A majority of nurses reported that the new tool conveyed necessary information (85% of nurses) and was effective in preventing errors (81% of nurses). CONCLUSION Multidisciplinary stakeholders guided the development and implementation of a standard handoff process and an EMR-based tool to optimize communication between nurses during patient transition. The intervention was associated with a reduction in the proportion of medication errors as the result of ineffective handoffs. In addition, the intervention improved communication between nurses.
AB - PURPOSE Ineffective handoffs contribute to gaps in patient care and medication errors, which jeopardize patient safety and lead to poor-quality care. The project aims are to develop and implement a standardized handoff process using an electronic medical record (EMR)–based tool to ensure optimal communication of treatment-related information for patients receiving cancer treatment between oncology nurses. METHODS A multidisciplinary team convened to develop a standard and safe treatment handoff process. The intervention was developed over a series of phases using Plan-Do-Study-Act methodology, including current workflow process mapping; identifying gaps, limitations, and potential causes of ineffective handoffs; and prioritizing these using a Pareto chart. An EMR-based tool incorporating a standardized treatment handoff process was developed. Study outcomes included proportion of handoff-related medication errors, tool utilization, handoff completion, patient waiting time, and nurse satisfaction with tool. All outcomes were evaluated before and after the intervention over a 1-year period. RESULTS The proportion of medication errors as a result of ineffective handoffs was reduced from 10 of 17 (60%) pre-intervention to 11 of 34 (32%) postintervention (P = .07). The EMR-based handoff tool was used in 9,274 of 10,910 (85%) patient treatment visits, and the handoff completion rate increased from 32% pre-intervention to 86% postintervention. Patient waiting time showed an average reduction of 2 minutes/patient/month. A majority of nurses reported that the new tool conveyed necessary information (85% of nurses) and was effective in preventing errors (81% of nurses). CONCLUSION Multidisciplinary stakeholders guided the development and implementation of a standard handoff process and an EMR-based tool to optimize communication between nurses during patient transition. The intervention was associated with a reduction in the proportion of medication errors as the result of ineffective handoffs. In addition, the intervention improved communication between nurses.
UR - http://www.scopus.com/inward/record.url?scp=85065902778&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065902778&partnerID=8YFLogxK
U2 - 10.1200/JOP.18.00245
DO - 10.1200/JOP.18.00245
M3 - Article
C2 - 30946643
AN - SCOPUS:85065902778
VL - 15
SP - E480-E489
JO - Journal of Oncology Practice
JF - Journal of Oncology Practice
SN - 1554-7477
IS - 5
ER -