A new study finds a patient safety measure that nurses and patients alike agree improves care: Involving patients in the handoff process when nurses change shifts.
Now more than ever, hospitals are working to find that elusive crossroad where patient safety and satisfaction meet to produce healthier, happier, and more engaged patients. But despite the money and energy spent on planning and launching new patient safety measures, there's often skepticism from the nurses who are tasked with actually carrying out such programs. A study earlier this year from the American Nurses Association and GE Healthcare, for instance, found that not much more than half of nurses (57%) believe that the patient safety programs in their hospital are effective.
But there is one patient safety measure that nurses and patients agree improves care: Involving patients in the handoff process when nurses change shifts, instead of nurses conducting handoffs at the nurses' station.
In fact, Fran Damian, MS, RN, NEA-BC, the ED nursing director at Boston Children's Hospital, credits doing handoffs in the patient rooms as one of the key measures that helped the hospital's ED win one of the Emergency Nurses Association's Lantern Awards.
On the flip side, the ANA-GE Healthcare study showed that 33% of nurses said that that "poor communication among nurses at handoff" is something that has increased the risk of patient safety incidents in their hospital in the past 12 months.
Now, a new study from St. Michael's Hospital in Toronto is providing additional firepower to the idea that involving patients in handoffs improves patient safety and satisfaction. Published last month in the Journal of Nursing Care Quality, the study shows that patients have a better understanding of and engagement in their care when handoffs are performed at the bedside. Now, after a 2011 pilot program, nurses on every medical and surgical unit at St. Michael's Hospital perform handover at their patient's bedside.
HealthLeaders Media caught up with the study's lead author, Lianne P. Jeffs, RN, PhD, St. Michael's Hospital Volunteer Association Chair in Nursing Research, via email to ask her about some of the study's key takeaways for nurses and nurse leaders.
HealthLeaders Media: Which of your study results did you find most important/surprising?
Jeffs: Bedside nurse handover is beneficial to both clinicians and patients as they improve and strengthen communication between both parties; reduce errors (e.g., medication); and strengthen the concept of patient-centered care. It is important to note that some patients may not want to participate in this type of handover and their preference should be acknowledged and accepted.
HealthLeaders: For working nurses, what are the most important takeaways from your study?
Jeffs: 1. Patients described the bedside nursing handover as engaging, personal, and informative. The bedside nursing handover created a space to connect with their nurses in a more personal manner (e.g., provided an introduction between patient and nurse at the beginning of the shift).
2. Patients found the experience increased their engagement in their own care and kept them informed about their health status and care plan. It also gave the patient an opportunity to identify important needs to the nurse (e.g., daily activities).
3. Not all patients wanted to participate in the bedside nursing handover, particularly … some of the long-term-stay patients.
HealthLeaders: How can nurse managers use/implement this data with their staff?
Jeffs: Nurse managers can use [the] study findings to demonstrate the benefits experienced by the patients receiving bedside handover and to ensure that patients' preferences around what aspects of their care should be discussed [during] the bedside handover.
HealthLeaders: How difficult would it be to implement this kind of change (i.e., making a workflow change)? Any tips for doing so?
Jeffs: [Leaders should consider] concerns around protecting patient privacy. [Also,] this type of reporting may take more time [and] need to be addressed as part of the change-management strategy.
Alexandra Wilson Pecci is an editor for HealthLeaders.
