Best Practice For Ed Handoff To Floors

The process for emergency department handoff with critical care and medical surgical units will be examined and reviewed at a local magnet hospital.

Best practice for ed handoff to floors. A study of hand off reports between pre hospital personnel and staff in the emergency department revealed a lack of complete or formal information dialogue. For years the inpatient medicine leaders at yale new haven ct hospital ynhh fielded complaint after complaint from house staff members and hospitalists about new admissions from the emergency department ed. We can access labs. There would be no name on the report and it s not unusual for us to get 3 patients at once.

Handoff processes the team at westmoreland hospital saw that improving the communication of information during this process could result in significant improvements in their ed boarding times and patient safety. However this environment produces barriers to effective communication making handoffs difficult. The barriers of the handoff will be examined to determine if there is room for improvement of the handoff process amongst the emergency department and floor units as evidence suggests. Why one quarter of ed to inpatient transfers are near misses.

The nurse clicked accept in the emr to indicate the care team was ready to receive the patient. Emergency departments are commonly thought to be overcrowded because they are not big enough to accommodate the needs of their communities. Laboratory handoff errors and omissions have been observed in 29 2 of handoffs. Most commonly the exchange takes place at a central location eg in the provider s work area or in front of a computer or a whiteboard.

For the inpatient caregiver the nurse is able to confirm exactly which medications were given what procedures were completed and that proper documentation is provided. Ed to inpatient transfers are flawed with safety gaps. A page notified the inpatient nurse of an admission triggering a review of applicable data in the system within 15 minutes. Handoff communication in the emergency department.

Handoffs may occur at the patient s bedside or in a central location. Eps thrive in the chaos of the emergency department handling trauma resuscitations and often a waiting room full of patients. Not to sidetrack the thread but the floor nurses sometimes have more info than the ed rn via the emr. The ed and ip nurses have the face to face chance to discuss exactly what took place in the ed and what the plan of care will look like now in inpatient.

There is little evidence available to support the superiority of either model as a best practice in the ed. The team piloted an electronic handoff process between the ed and two inpatient floors. The report would have a phone number for the ed nurse for questions but s he was never available their same complaint with us. The communication of patient information through use of handoff ensures continuity of care and patient safety.