Emergency Department (ED); Medical Handover; Communication Failure; Emergency Physician; Patient Safety
Abstract :
[en] AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care.
Disciplines :
Social & behavioral sciences, psychology: Multidisciplinary, general & others Public health, health care sciences & services
Author, co-author :
Gillet, Aline ; Université de Liège - ULiège > Département Psychologies et cliniques des systèmes humains > Ergonomie et intervention au travail
GHUYSEN, Alexandre ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
BONHOMME, Suzanne ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
D'ORIO, Vincenzo ; Centre Hospitalier Universitaire de Liège - CHU > Urgences
Nyssen, Anne-Sophie ; Université de Liège - ULiège > Département Psychologies et cliniques des systèmes humains > Ergonomie et intervention au travail
Language :
English
Title :
Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
Publication date :
June 2015
Journal title :
European Journal of Emergency Medicine
ISSN :
0969-9546
eISSN :
1473-5695
Publisher :
Lippincott Williams & Wilkins, London, United Kingdom
Gibson SC, Ham JJ, Apker J, Mallak LA, Johnson NA. Communication, communication, communication: the art of the handoff. Ann Emerg Med 2010; 55:181-183.
Horwitz LI, Meredith T, Schuur JD, Shah NR, Kulkarni RG, Jenq GY. Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med 2009; 53:701.e4-710.e4.
Randell R, Wilson S, Woodward P, Galliers J. Beyond handover: supporting awareness for continuous coverage. Cogn Technol Work 2010; 12: 271-283.
Wears RL, Perry SJ, Shapiro M, Beach C, Croskerry P, Behara R. Shift changes among emergency physicians: best of times, worst of times. Proc Hum Factors Ergo Soc 2003; 47:1420-1423.
Wears R, Perry S, Wilson S, Galliers J, Fone J. Emergency department status boards: user-evolved artefacts for inter-and intra-group coordination. Cogn Tech Work 2007; 9:163-170.
Ye K, McD Taylor D, Knott JC, Dent A, MacBean CE. Handover in the emergency department: deficiencies and adverse effects. Emerg Med Australas 2007; 19:433-441.
Catchpole KR, De Leval MR, McEwan A, Pigott N, Elliott MJ, McQuillan A, et al. Patient handover from surgery to intensive care: using formula 1 pit-stop and aviation models to improve safety and quality. Pediatr Anesth 2007; 17:470-478.
Cheung DS, Kelly JJ, Beach C, Berkeley RP, Bitterman RA, Broida RI, et al. Improving handoffs in the emergency department. Ann Emerg Med 2010; 55:171-180.
Sinha M, Shriki J, Salness R, Blackburn PA. Need for standardized sign-out in the emergency department: a survey of emergency medicine residency and pediatric emergency medicine fellowship program directors. Acad Emerg Med 2007; 14:192-196.
Wears RL, Perry SJ, Eisenberg E, Murphy L, Shapiro M, Beach C, et al. Transitions in care: signovers in the emergency department. Proc Hum Factors Ergon Soc Annu Meeting 2004; 48:1625-1628.
Dunsford J. Structured communication: improving patient safety with SBAR. Nurs Womens Health 2009; 13:384-390.
The Joint Commission. 2010 comprehensive accreditation manual for hospitals: the official handbook. Oakbrook Terrace, IL: Joint Commission Resources; 2009.
Woods DD, Hollnagel E. Joint cognitive systems: patterns in cognitive systems engineering. New York: CRC/Taylor & Francis; 2006.
Nyssen AS, De Keyser V, Renan S, Véronique DK. Improving training in problem solving skills: analysis of anesthetists' performance in simulated problem situations. Le travail Humain 1998; 61:387-401.
Simon HA. Models of man: social and rational; mathematical essays on rational human behavior in society setting. Oxford, England: Wiley; 1957.
Patterson ES, Wears RL. Patient handoffs: standardized and reliable measurement tools remain elusive. Jt Comm J Qual Patient Safe 2010; 36:52-61.
Cosby KS. A framework for classifying factors that contribute to error in the emergency department. Ann Emerg Med 2003; 42:815-823.
Bradley Morrison J, Rudolph JW. Learning from accident and error: avoiding the hazards of workload, stress, and routine interruptions in the emergency department. Acad Emerg Med 2011; 18:1246-1254.
Wears RL, Woloshynowych M, Brown R, Vincent CA. Reflective analysis of safety research in the hospital accident & emergency departments. Appl Ergon 2010; 41:695-700.
Bhabra G, Mackeith S, Monteiro P, Pothier DD. An experimental comparison of handover methods. Ann R Coll Surg Engl 2007; 89:298-300.
Karl R. Briefings, checklists, geese, and surgical safety. Ann Surg Oncol 2010; 17:8-11.
Solet DJ, Norvell JM, Rutan GH, Frankel RM. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med 2005; 80:1094-1099.
Nyssen AS. Integrating cognitive and collective aspects of work in evaluating technology. IEEE Trans Syst Man Cyber 2004; 34:743-748.
Hick JL, Hanfling D, Cantrill SV. Allocating scarce resources in disasters: emergency department principles. Ann Emerg Med 2012; 59:177-187.
Nundy S, Mukherjee A, Sexton JB, Pronovost PJ, Knight A, Rowen LC, et al. Impact of preoperative briefings on operating room delaysa preliminary report. Arch Surg 2008; 143:1068-1072.
