Safe patient hand-offs are a critical moment in time for everyone involved in the care of patients. The call to action inspired by the IOM White Paper, “To Err is Human,” emphasized the need to develop standardized methodologies that promote consistent communication amongst health care providers across the care continuum. As I reflect on this seminal work, I’ve come to realize that it’s been 13 years since publication and I ask myself, “How far have we come?” We are in an era when millions of people have technology at their fingertips via personal devices with thousands of instantly downloadable applications. However, how often when we drill down patient safety events do we find communication as the root cause?
My organization has been documenting patient care in an electronic medical record since 1996. I’m proud to say we are a front runner and well positioned to tackle the challenges of Meaningful Use. Yet when we observed nurses’ hand off methodologies one glaringly obvious gap was the way in which essential patient information was exchanged. Yes, we’d implemented a standard form and format for verbal hand-offs of care – “Situation, Background, Assessment, Recommendations” (SBAR). However, nurses still had to hand write information already documented in the EMR on a paper SBAR form. Finally, IT resources were dedicated to partner with nurses to create an electronic SBAR report sheet. This tool pulls essential patient information contained within the EMR into a clear, succinct document used to facilitate bedside hand-offs.
Since implementation, the “eSBAR” has standardized and streamlined hand-offs of care between shifts and during transfers between units. It’s been so well -received that we’ll soon use it for transfer to extended care facilities and from our Emergency Department. As opportunities to leverage technologies arise, it is critical that nurse leaders leverage their influence to insist that IT applications are resourced in ways which support front line caregiver communication.
– Trece Gurrad, MSN, RN, Regional Director, Acute Care Services at PeaceHealth St John Medical Center, Longview[/two_third]
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