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Patient Care Hand Off
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Patient Care Hand Off

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A critical safety and quality problem in the United States, patient care hand-off has been described as “The Bermuda Triangle of Healthcare”. Miscommunication is so common that it’s been found that ED ...

A critical safety and quality problem in the United States, patient care hand-off has been described as “The Bermuda Triangle of Healthcare”. Miscommunication is so common that it’s been found that ED staff members remember less than half of the information that EMS relays during verbal reports. Occurring many thousands of times a day and each and every patient hand-off is an opportunity for either failure or success. Using the right techniques, healthcare providers can do more than just avoid an “uh-oh” moment, we can speed the delivery of critical patient care to our patients who need it most.


Objectives: Students will learn:
1) The potential failure points in hand off that directly affect patient care.
2) Common communication errors that occur
3) The SBAR +Q method for verbal reports.
4) The SHARE method for implanting a hand-off improvement initiative.


www.romduckworth.com

Published in: Salud y medicina, Tecnología
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  • Begin every class no mater where thinking…For years at the beginning of every course that I taught I explained to my students that no matter where they were Practicing EMS I was teaching them like any one of them could be responding to care for the people that I cared about.
  • 2006 WSJ health columnist Laura Landro referred to patient handoffs as “The Bermuda Triangle of health care.”
  • Please indicate the correct response in this section – if there is a correct response.
  • This will help address specific issues that you identify.
  • Vertical up to intervention, critical care, etc.Horizontal across trauma, cardiac, medical, etc.
  • Standardize Critical Content Hardwire Within Your System Allow QuestionsReinforce Quality Educate and Coach
  • Transcript

    • 1. http://www.flickr.com/photos/christianacare/9915278814/
    • 2. Doctors Nurses Paramedics EMTs Allied Health
    • 3. First Response to Ambulance Ambulance to Paramedic Paramedic to ED ED to Interventional Staff Interventional Staff to Critical Care Staff And so on…
    • 4. http://www.flickr.com/photos/meganpatapoff/6545674775/lightbox/
    • 5. Delay in treatment Inappropriate treatment Adverse events Omission of care Increased hospital length of stay Avoidable readmissions Increased costs Inefficiency from rework Other minor or major patient harm.
    • 6. Culture: Lack of teamwork and respect Expectations between sender and receiver differ Ineffective communication method, e.g. verbal, recorded, bedside, written Timing of physical transfer of the patient and the hand-off are not in sync Inadequate amount of time provided for successful hand-off Interruptions occur during hand-off Lack of standardized procedures in conducting successful hand-off Inadequate staffing to accommodate successful hand-off Patient not included during hand-off http://www.flickr.com/photos/christianacare/5395571917 /
    • 7. Sender provides inaccurate or incomplete information, e.g. medication list, DNR, concerns/ issues, contact information Sender, who has little knowledge of patient, is handing off patient to receiver Sender unable to provide up-to-date information, e.g. lab tests, radiology reports, because not available at the time of hand-off Inability of sender to follow up with receiver if additional information needs to be shared Sender asked to repeat information that has already been shared http://www.flickr.com/photos/christianacare/5395571917 /
    • 8. Receiver has competing priorities and is unable to focus on transferred patient Receiver unaware of patient transfer Inability for receiver to follow up with sender if additional information is needed Lack of responsiveness by receiver Receiver has little knowledge of patient being transferred http://www.flickr.com/photos/christianacare/5395571917 /
    • 9. Glasgow Coma Scale GCS Face Arm Speech Time ER FASTER Boston Operation Stroke Scale BOSS Cincinnati Prehospital Stroke Scale CPSS Melbourne Ambulance Stroke Screen MASS Age, Blood Pressure, Clinical Features, Duration Score ABCD Brooklyn Stroke Scale Los Angeles Prehospital Stroke Screen LAPSS Miami Emergency Neurological Deficit Checklist MEND National Institute of Health Stroke Scale NIHSS
    • 10. http://www.flickr.com/photos/36285585@N06/5784409606/
    • 11. http://www.flickr.com/photos/59553414@N05/5534068944/
    • 12. Situation Background Assessment Recommendations Age/Gender Point of Entry / CC Priority Concerns MOI/NOI/Onset Priority Med Hx. High Risk Meds Vital Signs Pert. Physical Findings Scales / Scores Treatment & Response Recap Requests
    • 13. Mechanism Injuries / Illness Symptoms Treatment Age/Gender Point of Entry / CC Priority Concerns MOI/NOI/Onset Priority Med Hx. High Risk Meds Vital Signs Pert. Physical Findings Scales / Scores Treatment & Response Recap Requests
    • 14. Conditions Actions Needs
    • 15. ABC’s Moment of Silence Allow Time Echo Answer
    • 16. Questions Quantify Qlarify http://www.flickr.com/photos/miwo76/30807445/
    • 17. Reduce errors! Facilitate the continuum of care!
    • 18. http://www.flickr.com/photos/accidental_julie/138348665/ Standardize Hardwire Allow Questions Reinforce Educate & Coach
    • 19. http://www.flickr.com/photos/22458831@N04/3676369069/

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