Development and Implementation of an Electronic Health Record Generated Surgical Handoff and Rounding Tool

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This is a review of the article Development and Implementation of and Electronic Health Record Generated Surgical Handoff and Rounding Tool from the Journal of Medical Systems. [1]

Background

It has been found that many hospital errors are a result of inadequate communication. A large pediatric hospital in Ohio conducted a study to determine if there was a change in safety, accuracy, and efficiency following a departmental change of utilizing a Microsoft Access Database (MAD) for handoff reports, to a handoff report automatically generated by EPIC electronic health record.

Methods

The researchers utilized a qualitative study method to survey clinicians regarding both types of handoff methods. The were asked to evaluate their perceived efficiency of the methods, the accuracy, and to rate the list compared to the methods used in different specialty areas. The researchers also used the hospital databases to determine any changes in adverse events following the change.

Results

The researcher found that 19% of the MAD records contained inaccuracies, while none of the EPIC records had any inaccuracies. The surveys also showed that clinicians reduced time managing the lists by 43 minutes per week; while at the same time, the clinicians found the EPIC system to generally safer, more efficient, and overall good to very good.

Conclusion

While the results are limited, the overall success of this system was apparent. With these results, the researchers concluded that perceived benefits to patient safety, and overall accuracy coupled with advancements in mobile technology will be the way of the future.

Article Analysis

Communication is essential for providing quality care to all patients, and with increased technology and electronic health records clinician require new innovative methods to improve communication while still ensuring safety to all the patients. By developing a method to “capture” all the pertinent data from an electronic health record and creating a quick, understandable, reference to be used when transitioning a patient from one clinician to another, informaticians can facilitate a smooth, efficient, accurate, and safe transition. Many EHRs already contain the information that clinicians need, the key is to develop a way to have it readily accessible. This study clearly demonstrated that despite limitations, and some negative aspects (more pages printed) that patient safety and clinician evaluation can be improved by incorporating EHRs into handoffs.


References

  1. Raval, M., Rust, L., Thakkar, R., Kurtovic, K., Nwomeh, B., Besner, G., Kenney, B., Development and Implementation of an Electronic Health Record Generated Surgical Handoff and Rounding Tool. Journal of Medical Systems 39 (8), 2015.http://www.ncbi.nlm.nih.gov/pubmed/?term=Development+and+Implementation+of+an+Electronic+Health+Record+Generated+Surgical+Handoff+and+Rounding+Tool