Improving perceptions of patient safety through standardizing handoffs from the emergency department to the inpatient setting: a systematic review

Abstract

Background and purpose: Patient handoffs have long been identified as a potentially challenging time for patients because poor communication produces numerous complications. This is especially true with regards to patient care handoffs between areas such as the emergency department (ED) and inpatient setting. The purpose of this systematic review is to analyze existing literature pertaining to standardized handoffs between the ED and inpatient setting and its effect on perceived patient safety to guide future research, clinical practice, and patient safety. Methods: A review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were selected using predetermined inclusion/exclusion criteria: primary research and patient handoff from the ED to the inpatient setting. Quality assessment of the studies was completed using The Joanna Briggs Institute critical appraisal tool. Conclusion: Existing studies demonstrate the potential for increased perception of patient safety as well as provider satisfaction when appropriate staff education and standardized handoff tools are implemented. There is a lack of data on the standardization of handoff tools between the ED and inpatient setting and their impact on perceived patient safety. Implications for practice: The combination of provider education and implementation of standardized handoff tools in the ED positively affects perceptions of patient safety and provider satisfaction. Hospital administrations should strongly consider incorporating standardized handoff tools into practice.

Quality measures of clinical pharmacy services during transitions of care

“…118 Use of standardized forms used during a variety of transfers between levels of care has improved communication of patients' advanced directives, safety perceptions, patient satisfaction, and other outcomes. 9,10,19,[119][120][121] Standardized handoff tools together with coordinated medication reconciliation increase patient satisfaction regarding medication knowledge and meeting healthrelated goals, especially when speaking with a pharmacist about their medications. 25 Unlike studies assessing patient satisfaction with institutional services, the Task Force has identified no recent studies of prescriber satisfaction or engagement with pharmacy TOC services.…”

Strategies to measure and improve emergency department performance: a scoping review

“…Seven reviews examined interventions relating to patient handover processes and transitions in care. Patient handover processes and transitions in care interventions include handover tools [27][28][29][30], bedside registration [19,31], discharge planning [31], discharge communication [32], process protocols and guidelines [27,29,30], handover training [29], dedicated offload nurse for triaging and assessing EMS patients [30], nurse discharge coordinators [33]. A description of the characteristics for each Graphical presentation for ROBIS results across all included reviews.…”

“…These included advanced nursing roles, physiotherapy, general practitioners, scribes and physician assistants, pharmacy, and mental health services, as well as the development of professional skills. [28]. For example, Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) is a tool for face-to-face beside handover [27][28][29][30].…”

“…[28]. For example, Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) is a tool for face-to-face beside handover [27][28][29][30]. Other tools include Situation, Background, Assessment, Responsibilities and Risks, Discussion and Disposition, Read-back and Record (SBAR-DR) model for verbal handoff, Mechanism of Injury/Illness, Injuries, Signs, observations and monitoring, and Treatment given (MIST; DeMIST includes Demographic information to the handover), hospital developed handover tools, as well as written handover, handover added to patients paper chart, and an eSignout step added to the ED dashboard [27][28][29][30].…”

Using simulation to help healthcare professionals relaying patient information during telephone conversations

“…Challenges in interprofessional cooperation can compromise the care for patients [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. The challenges are rooted in different aspects, including communication problems [ 9 , 10 , 11 , 12 ], or hierarchical power structures [ 13 , 14 , 15 ]. While growing into the field, roles, norms, values and beliefs are formed [ 16 , 17 , 18 ] and thus different aspects of care might be prioritized differently depending on professions and specialties [ 19 , 20 , 21 , 22 , 23 , 24 , 24 ].…”