Hospitals in pursuit of excellence

Improving Handoffs for Patients!

To expertly execute a dribble handoff in basketball, communication between teammates is key. How to effectively execute end-of-shift patient handoffs? Again, communication is key. The traditional nursing end-of-shift handoff process at University of Missouri Health Care, Columbia, Mo., involved nurses recording or listening to summaries and writing or reviewing handwritten notes. Nurses spent little time talking directly to each other or involving the patient. A new face-to-face handoff process at the bedside was designed, tested and revised. "Nurse champions and 'super users' played critical roles in the intervention design and revision process," says Roland Ragan, RN. The structured handoff process includes introductions between staff, patient and family members, basic clinical updates, care goals, current concerns and patient questions. Staff members used a scripted outline to practice. With the new process, patient satisfaction scores related to nursing increased from the 20th to 40th percentiles to the 95th percentile and above. For more information, contact Ragan at raganr@health.missouri.edu.