Editor's Note Hospitals can avoid medical-surgical patient handoff errors by using a web-based handoff tool to improve communication among physicians, nurses, and other healthcare providers, this study finds. Of 5,407 patients included in the study, 77 errors were detected before implementation of the handoff tool versus 45 after implementation. Brigham…
Editor's Note Technical and nontechnical skills are both important to successfully and safely perform surgical procedures, according to recommendations presented August 5 at the National Surgical Patient Safety Summit in Rosemont, Illinois. Among the recommendations were that the surgeon, anesthesiologist, nurses, and support staff ensure consistent use of surgical safety…
Editor's Note The Joint Commission on January 25 announced that Parrish Medical Center, Titusville, Florida, is the first hospital to be awarded its Integrated Care Certification. The Joint Commission began offering the certification in July 2015 to recognize hospitals and ambulatory care settings that excel at integrating information-sharing, transitions of…
Editor's Note Ambiguous roles and conflicting expectations of team members during OR to intensive care unit (ICU) handoffs can increase risk of patient harm, this study finds. Researchers conducted 38 interviews of clinicians involved in OR to ICU handoffs to characterize the relationship between handoff process failures and patient harm.…
Editor's Note Based on their analysis of systems and processes involved in OR to intensive care unit (ICU) handoffs, researchers from Northwestern University Feinberg School of Medicine, Chicago, and Washington University School of Medicine, St Louis, made recommendations to reduce potential for patient harm. These included automated transfer of OR…
Editor's Note Patient handoffs in ambulatory surgery centers are commonly interrupted by distractions that put patients at risk, and nearly 50% might be preventable, this study finds. Handoffs with communication distractions were rated lower in overall quality and associated with a greater number of errors (ie, transfer of incorrect information).…
The main distinction between good and bad debriefings comes down to the level of staff engagement. That’s what the surgical team at the University of Colorado Hospital, Aurora, learned during a project designed to improve the quality of the 30- to 60-second conversations held after surgery. “In a good debriefing,…
Working for a small facility after spending many years at a large one can present a host of leadership challenges, but meeting those challenges with process changes and improved efficiencies can be highly satisfying. After serving more than 23 years at the Cedar Crest campus of Lehigh Valley Health Network…
After a poor handoff from the OR to the postanesthesia care unit (PACU) was identified as the culprit behind a serious adverse event, Nancy Robinson, DNP, MSN, RN, LHRM, CCM, made it her mission to avoid a recurrence. “I’m passionate about safe patient hand-offs,” says Robinson. “I didn’t want this…
Hospitals are taking lessons from the high performance of Formula 1 racing pitstop crews and applying them to handoffs between the OR and the ICU. "The hand- off is like a pit stop: surgery is the first section of the race, the second part is intensive care, and the handoff…