Towards an understanding of the information dynamics of the handover process in aged care settings—A prerequisite for the safe and effective use of ICT

Lyhne, Svend Ahrensback; Georgiou, Andrew; Marks, Anne; Tariq, Amina; Westbrook, Johanna I.

doi:10.1016/j.ijmedinf.2012.01.013

Cited by 29 publications

(49 citation statements)

References 17 publications

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“…There is some evidence to suggest that electronic nursing documentation systems encompassing electronic progress notes, care plans, handover sheets, scheduling and funding calculations within facilities reduce the time spent on documentation [22]. Electronic documentation systems could also potentially reduce the time spent at handover as nurses would not have to search for information from different locations as is currently performed [23]. However, prior evidence, as well as the findings from this study, suggest that internal facility electronic documentation systems either make no difference or even increase documentation time [24-26].…”

Section: Discussionmentioning

confidence: 99%

Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

Gaskin

Georgiou

Barton³

et al. 2012

BMC Geriatr

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BackgroundThe provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals.MethodsA survey of staff (n = 119), including managers, health informatics officers (HIOs), quality improvement staff, registered nurses (RNs), enrolled nurses (ENs)/endorsed enrolled nurses (EENs) and assistants in nursing (AINs) was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT) capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes.ResultsStaff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents after hospital discharge.ConclusionsThis survey identified a high volume of information exchange activities, as well as inefficient procedures, such as the transfer of information from paper to computer systems and the reliance upon faxes for communication with external providers. These findings contribute to evidence for the need for interoperable IT systems to allow more efficient and reliable information exchange between facilities and external providers.

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Section: Discussionmentioning

confidence: 99%

Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

Gaskin

Georgiou

Barton³

et al. 2012

BMC Geriatr

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“…One of the authors, experienced in conducting qualitative research in RACFs, [38,39] collected data over three months (May to July 2011) during which 22 days were spent observing work processes. All aspects of the RACF work which related to the MIR process were studied.…”

Section: Methodsmentioning

confidence: 99%

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

2012

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BackgroundMedication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs.MethodsThe study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach.ResultsThe findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs.ConclusionsThis study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

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“…barriers to access up-to-date and resident-specific information, duplication of information, no clear pathway of gathering information and a lack of standardized procedures during handovers [32] and insufficient preparation during the pre-handover process [37].…”

Section: Types Of Errorsmentioning

confidence: 99%

How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review

Flemming¹,

Hübner²

2013

International Journal of Medical Informatics

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Towards an understanding of the information dynamics of the handover process in aged care settings—A prerequisite for the safe and effective use of ICT

Cited by 29 publications

References 17 publications

Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review

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