When Kathleen Mikos, RN, MSN, vice president of patient care, chief nursing officer, came to Ingalls Memorial Hospital in Harvey, IL, she couldn't shake the sense of déjà vu when she found that patient handoffs took an hour to 90 minutes to complete.
At her previous hospital, Mikos had dealt with a similar issue. The lengthy amount of time became an issue with incremental overtime and also got in the way of patient care.
Drawing on her past experience, in May 2008 Mikos began to develop a new, efficient method for patient handoffs that allowed for more patient/nurse interaction and reduced nurse overtime at Ingalls.
For years, nurses nationwide have used different methods for handling handoff reports. One technology was the use of taped records. This caused problems because if an interruption occurred while the nurse was reporting, the nurse had to make a note on the recorder where the tape left off, causing confusion later on.
There were also instances when the tape recorder broke or someone had recorded over a report, causing the nurses to take more time to re-record each patient report.
More recently, handoffs involved nurse-to-nurse interaction between shifts. As the nightshift was coming on and the day shift was leaving, and vice versa, the nurses discussed each patient and how the shift went.
Although effective, this process takes a lot of time, and many nurses went into overtime at Ingalls.
"Between shifts, as 10 nurses are coming on and 10 nurses are leaving, I can have up to 20 nurses tied up," says Mikos. "Having that many nurses tied up, trying to get reports, cuts into the patient care."
Much of the delay occurred because not all nurses shared the same patients. Most of the time, those nurses who were starting their shifts had to track down the nurses who had their patients during the previous shifts.
To solve this problem, Mikos turned to The White Stone Group, Inc., for a technological solution to facilitate a new handoff process. This company provides healthcare organizations with software to help improve the management of healthcare communication events.
Having had experience with The White Stone Group in the past, Mikos was confident in setting up OptiVox, a voice technology program for handoffs, and made the program accessible to all staff members through any telephone in the hospital system.