Miscommunication between care teams in hospitals during patient transitions can have serious consequences. According to the Agency for Healthcare Research and Quality, 70 percent of deaths caused by medical errors are related to communication breakdowns during care team handoffs.
Joanna Abraham, assistant professor of biomedical and health information sciences in the University of Illinois-Chicago’s College of Applied Health Sciences, contends that ineffective handoffs can lead to omissions and inaccuracies in the information shared among clinicians, with negative effects on patient safety.
Typically, these breakdowns in communication constitute a failure in information flow and transfer from the outgoing post-call care team to the on-call team, Abraham notes. However, a Handoff Intervention Tool (HAND-IT) has been shown to lead to fewer transition miscommunications.
“Structured tools such as HAND-IT can serve as cognitive support for promoting effective communication, as it allows the incoming clinician to know what to expect during the presentation and to quickly identify any discrepancies or gaps in the ongoing communication and instantaneously repair them,” concludes a new study published in the Journal of Medical Internet Research-Human Factor.
The two-month study was conducted in a medical intensive care unit comparing two rounding tools—HAND-IT and SOAP (Subjective, Objective, Assessment and Plan)—involving a total of 82 patient cases and using audio recordings of observed rounds.
Researchers reported that “although HAND-IT required more effort and time to gather and document information, it reduced the time spent and additional effort during rounds to address the information gaps.”
HAND-IT is organized by body systems including pulmonary, neurology, endocrine, hematology, cardiovascular, infectious disease, and renal and genitourinary organ systems. The information within each body system is organized in a medical knowledge hierarchical format.
“This study shows that the use of structured rounding tools mitigates disproportionate time allocation and communication breakdowns during rounds,” says Abraham. “With the more structured HAND-IT tool, these effects were almost completely eliminated.”
“Our results help to demonstrate the benefits of using structured rounding tools for reducing communication errors and improving patient care quality and safety. Although our results are preliminary, they present a strong case for further research into rounding communication,” she adds.
While HAND-IT is a paper-based communication rounding tool, Abraham says there are plans to incorporate it into an electronic health record system.
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