Hopefully, the 23% of survey respondents who said they do not have a form have an appropriate process in place, says Elizabeth Di Giacomo-Geffers, RN, MPH, CNAA, BC, a healthcare consultant in Trabuco Canyon, CA, former Joint Commission surveyor, and member of the AHAP advisory board.
"The 27% that do not make the form part of the permanent record does not match the 23% that do not have a form," she says. "They must use something else, like a 'ticket to ride.' "
It's not surprising that most organizations have a form, says Gayla J. Jackson, RN, BSN, nurse manager at Mount Auburn Hospital in Cambridge, MA, and also a member of the AHAP advisory board. "It seems like we are all experimenting with different types of forms to help the process."
Jackson isn't surprised, either, that few organizations are making handoffs part of the permanent record. "Nor do I think they should," she says.
Thirty-seven percent of AHAP members who responded to the survey said they have one handoff form for the entire organization, while another 37% said they have many, department-specific forms.
"With many, department-specific forms, how is the process standardized?" asks Di Giacomo-Geffers.
"I have seen and heard of different forms used on specific units to facilitate change-of-shift reports," says Jackson.
"Every unit has its own specific type of change-of-shift report. And most organizations do not want to upset the 'unit thing.' We are trying to use the same form for handoffs between units and for tests," she says. "And that does make sense."
According to the survey, of the organizations that use many, department-specific handoff forms, 72% have a standardized component in each form.
Keeping one part of the form standardized is important, says Jackson. "That is the part that ensures we meet all the implementation expectations for this National Patient Safety Goal."
Sixty-six percent of AHAP members responding to the survey reported that they use SBAR to help staff remember their handoff process. While 14% reported using another creative tool, 20% said they do not use a creative tool.
For those that do not using a creative tool, the assumption is that they already communicate effectively, says Di Giacomo-Geffers. "But most hospitals are struggling to come up with a tool that will work for all parts of the hospital," adds Jackson.
For the 80% that did report using a creative tool to help staff remember their handoff process, 49% reported that their tool is paper-based, 6% said their tool is electronic, and 45% said their tool is a combination of both.
"We use a combination-paper for the specific units and electronic for the transfers and procedures," says Jackson.
Regardless of the approach AHAP members are using to help staff remember the handoff process, it appears to be working--100% of those surveyed in the past year reported that The Joint Commission rated their handoff process as compliant.
"That 100% indicates they are doing something right," says Di Giacomo-Geffers, "or surveyors missed opportunities for improvement."
The handoff requirements are not too hard to comply with, add Jackson, "as long as your staff can speak to the required components as listed in the implementation expectations."