Standardized Electronic Handoff Adherence and Its Effects on Post-Operative Patients

Abstract

Problem & Purpose: Patients in the post-anesthesia care unit (PACU) of a midsize community hospital experienced average wait times of 80 minutes and median times of 35 minutes post-anesthesia discharge due to suboptimal handoff and communication to the inpatient telemetry unit, as illustrated by chart audit performed during the month before project implementation. Lack of communication contributed to fourteen reported adverse patient events on the telemetry unit over six months in 2023. The literature base supports the implementation of standardized electronic handoff (SEH) to improve throughput, communication, patient safety, and decrease medication errors. This quality improvement) project aims to measure adherence to the implementation of SEH for patients from PACU to the telemetry unit and the effects on communication and throughput. Methods: PACU staff entered SEH using a dot phrase in the patient’s chart under the notes section. The telemetry nurse read the SEH and called for any additional report questions prior to patient transfer to the floor. After the patient transferred, the receiving telemetry nurse completed a communication satisfaction survey using QR codes available on the unit. The project lead performed chart audits to determine throughput times and evaluated completed surveys for nurse perception of handoff. Results: Average transfer times dropped from 80 to 51 minutes; however, median times went from 35 to 43 minutes but remained under the goal of 60 minutes or less. At 11% compliance, nurses agreeing to positive questions about handoff increased from 78% to 81% and disagreeing to negative questions improved from 57% to 82%. Conclusion Practice recommendations include the implementation of SEH. Findings suggest adherence to SEH use, correlates to improved transfer times from PACU to the telemetry unit and improved communication perception with handoff. Keywords: Electronic, Handoff, Communication, Perception, Adherence, Throughput, Time