Improving Patient Throughput With an Electronic Nursing Handoff Process in an Academic Medical Center: A Rapid Improvement Event Approach. 2020

Emily Read Sermersheim, and Mark Chun Moon, and Marisa Streelman, and Denina McCullum-Smith, and Janine Fromm, and Stephanie Yohannan, and Rhonda Powell
Author Affiliations: Manager of Specialty Nursing in the Professional Nursing Practice (Dr Sermersheim), Project Lead of Clinical Applications in the Clinical Information Systems (Mr Moon), Unit Director (Dr Streelman), Assistant Unit Director of Post Anesthesia Care Unit (Ms McCullum-Smith), Registered Nurse in the Emergency Department (Ms Fromm), Unit Director of Neurosurgical Intensive Care Unit (Dr Yohannan), and Bed Management RN in the Patient Placement Department (Ms Powell), Rush University Medical Center, Chicago, Illinois.

OBJECTIVE Rush University Medical Center nursing leadership undertook a process improvement project to revamp nursing handoff during unit transfer with the goal of improving patient throughput. The aim was to decrease assign-to-occupy time, the duration from bed assignment to bed occupancy. BACKGROUND There was a lengthy lag time in admitting/transferring patients, leading to delays in patient throughput and potential threats to patient safety. In fiscal year 2016, assign-to-occupy time averaged 97 minutes. The goal was to decrease that time to 60 minutes or less. METHODS Process improvement leaders held a rapid improvement event to determine viable solutions. A team then standardized handoff workflow; created an electronic tool, virtually eliminating verbal report; and implemented a new handoff process. RESULTS Assign-to-occupy time at 1 year after go-live averaged 55 minutes, and it has been staying less than 60 minutes since the implementation. CONCLUSIONS Key success strategies included engaging stakeholders during the rapid improvement event, imploring frontline nurses to create and promote the revised process to facilitate staff engagement, and leveraging electronic health records.

UI MeSH Term Description Entries
D010360 Patient Transfer Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided. Patient Dumping,Care Transition,Health Care Transition,Patient Transition,Patient Turfing,Transition of Care,Care Transition, Health,Care Transitions,Care Transitions, Health,Dumping, Patient,Health Care Transitions,Patient Transfers,Patient Transitions,Patient Turfings,Transfer, Patient,Transfers, Patient,Transition, Care,Transition, Health Care,Transition, Patient,Transitions, Care,Transitions, Health Care,Transitions, Patient,Turfing, Patient,Turfings, Patient
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000046 Academic Medical Centers Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc. Medical Centers, Academic,Medical Centers, University,University Medical Centers,Academic Medical Center,Center, Academic Medical,Center, University Medical,Centers, Academic Medical,Centers, University Medical,Medical Center, Academic,Medical Center, University,University Medical Center
D017063 Outcome Assessment, Health Care Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). Assessment, Outcome,Outcome Assessment,Outcome Assessment (Health Care),Outcomes Research,Assessment, Outcomes,Outcome Measures,Outcome Studies,Outcomes Assessment,Assessment, Outcome (Health Care),Assessments, Outcome,Assessments, Outcome (Health Care),Assessments, Outcomes,Measure, Outcome,Measures, Outcome,Outcome Assessments,Outcome Assessments (Health Care),Outcome Measure,Outcome Study,Outcomes Assessments,Research, Outcomes,Studies, Outcome,Study, Outcome
D017598 Efficiency, Organizational The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, material, etc. Efficiency, Administrative,Productivity, Organizational,Program Efficiency,Administrative Efficiency,Organizational Productivity,Efficiency, Program,Organizational Efficiency,Program Efficiencies
D057188 Workflow Description of pattern of recurrent functions or procedures frequently found in organizational processes, such as notification, decision, and action. Work Flow,Work Flows,Workflows
D057286 Electronic Health Records Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online CONSUMER HEALTH INFORMATION that is relevant to the health conditions and treatments related to a specific patient. Electronic Health Record Data,Electronic Medical Record,Electronic Medical Records,Computerized Medical Record,Computerized Medical Records,Electronic Health Record,Medical Record, Computerized,Medical Records, Computerized,Health Record, Electronic,Health Records, Electronic,Medical Record, Electronic,Medical Records, Electronic
D058996 Quality Improvement The attainment or process of attaining a new level of performance or quality. Improvement, Quality,Improvements, Quality,Quality Improvements
D061214 Patient Safety Efforts to reduce risk, to address and reduce incidents and accidents that may negatively impact healthcare consumers. Patient Safeties,Safeties, Patient,Safety, Patient
D062209 Patient Handoff The transferring of patient care responsibility from one health-care professional to another. Clinical Handoffs,Clinical Handover,Nursing Hand Off,Nursing Hand Offs,Nursing Hand Over,Nursing Hand Overs,Nursing Handoff,Nursing Handover,Patient Hand Off,Patient Hand Offs,Patient Hand Over,Patient Hand Overs,Patient Handover,Patient Sign Out,Patient Sign Outs,Patient Signout,Patient Signover,Clinical Handoff,Clinical Handovers,Hand Off, Nursing,Hand Off, Patient,Hand Offs, Nursing,Hand Offs, Patient,Hand Over, Nursing,Hand Over, Patient,Hand Overs, Nursing,Hand Overs, Patient,Handoff, Clinical,Handoff, Nursing,Handoff, Patient,Handoffs, Clinical,Handoffs, Nursing,Handoffs, Patient,Handover, Clinical,Handover, Nursing,Handover, Patient,Handovers, Clinical,Handovers, Nursing,Handovers, Patient,Nursing Handoffs,Nursing Handovers,Patient Handoffs,Patient Handovers,Patient Signouts,Patient Signovers,Sign Out, Patient,Sign Outs, Patient,Signout, Patient,Signouts, Patient,Signover, Patient,Signovers, Patient

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