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Tuesday, 19 November 2013: 10:20 AM
Learning Objective 1: Describe the application of the Lean Six Sigma Work Out process to improving handoffs.
Learning Objective 2: Review measureable outcomes as a result of improving the unit-to-unit handoff process.
Handoffs between hospital units create opportunities for gaps in patient safety due to missed information and miscommunication. Sharp Mary Birch Hospital for Women & Newborns, a free-standing women’s hospital with ~8,600 deliveries per year, has a high volume of unit-to-unit handoffs. The hospital implemented a quality improvement project in accordance with the 2006 Joint Commission National Patient Safety Goal 2E to improve the handoff process. The Lean Six-Sigma Work-Out process was used to review current practices and develop an improvement plan. A Work-Out is a process designed to bring the right stakeholders together to develop solutions and actions. The Work-Out group developed and implemented a standardized report checklist and a face-to-face bedside handoff process for unit-to-unit patient transfers. A voice-over Power Point presentation was utilized for staff education, and a “WELCOME” pneumonic was developed to help staff remember the key components of the handoff. The face-to-face handoff process was implemented in two phases, first between Labor & Delivery to postpartum, followed by Post Anesthesia Care to postpartum. The global rating on the HCAHPS survey increased from the 84th percentile prior to the project to the 99th percentile after implementation, and Communication with Nurses increased from the 80th percentile to the 96th percentile. Improvements are expected in the 2013 AHRQ survey as compared to the 2012 survey, particularly in the areas of Handoffs and Transitions (55% positive) and Teamwork Across Units (63% positive). Staff survey feedback regarding the new process was 64% positive in the first phase, and 82% positive in the second phase, noting benefits of adjustments that were made after the first phase. Implementing face-to-face handoffs for unit-to-unit transfers provides an opportunity to improve patient safety, patient satisfaction, and staff perception of safety and collaboration.