viernes, 11 de julio de 2008
IMPROVING PATIENT HANDOFFS
(Handoffs: The act or an instance of passing something or the control of it from one person to another)
Hundreds of service handoffs take place everyday when hospitalized patients are transferred between caregivers and units. Ideally, handoff transfer of patient care responsibilities occurs without a break in activities. A successful handoff avoids unwarranted changes in patient care goals, decisions, or plans, including dropping or reworking activities that others were told would be done by the previous caregiver. An increasing number of studies show that traditional methods of gathering patient data, organizing it, and communicating it among caregivers may not support high quality patient care. Practitioners must move beyond long-standing practices of information transfer (based on a one-way monologue) and toward a more effective system of information exchange (based on two-way dialogue).
Improving information exchange during service handoffs starts with clarifying the intent. What is considered a handoff and what are caregivers trying to achieve during these handoffs? Handoffs don’t only occur at shift change or at transition points (admission, transfer between units, discharge). During a patient’s day, there may be multiple patient handoffs – junior resident to senior resident, physician to nursing staff, surgery team to recover room staff, nurse to nurse handoffs. Common examples of potentially critical handoffs are shift changes for nursing staff and residents and transfer of patient care responsibilities from one physician to another or from one medical team to another, such as after a patient has had surgery and is transported to the post-anaesthesia recovery unit. Even seemingly routine handoffs, such as transport of an inpatient to the nuclear imaging department can be problematic if there is poor communication among caregivers. For instance, in one hospital an MRI technician described a situation in which she had particularly difficult time calming a patient during a test – only to find out later that the man was deaf. This vital information was never relayed to the technician when the patient was transported from the inpatient unit.
Don’t overlook handoff situations that involve other facilities or post-discharge caregivers, such as when patients are transferred to another hospital or discharged home for home care services. The transfer of inpatient care by a hospitalist to outpatient care by the patient’s primary physician is another example of a potentially critical handoff.
Ask caregivers involved in each type of handoff to describe what is considered safe and effective transfer of information. Use the questions below as a starting point in this discussion. * Who is primarily responsible for ensuring satisfactory information exchange?* What key communication steps need to be followed?* What minimal information needs to be communicated? * How should information be exchanged?* Who should be involved in this exchange?
It is essential that people work together as a team to identify the minimal set of information that needs to be imparted during the handoff and how best to accomplish the communication. With so many individuals involved in the care of patients, it is important for everyone to agree on minimal standards for information exchange. The communication mechanism may vary from unit to unit or situation to situation, however the same essential information should be communicated during a handoff. The specific information will vary according to the situation.
Whatever process changes are made to improve exchange of information during patient handoffs, caregiver training in communication techniques is also important. Safe and effective handoff communications depend on the ability of caregivers to prioritize relevant information and transfer insights effectively. Practitioners and staff often have had no formal training in handoff communication; it is often just learned on the job. No matter how efficient the handoff process becomes, the proper information exchange won’t take place if people don’t have the right communication skills.
Taken from: http://www.brownspath.com/original_articles/improvpatho.htm
Exercise:
Read the article “Improving patient handoffs” and decide if the following statements are true or false:
1. Only few handoffs take place every day in hospitals. _______
2. A successful handoff avoids unwarranted changes in patient care goal._____
3. An increasing number of studies show that traditional methods of gathering patients data, organizing it, and communicating it among caregivers support high quality patient care. _____
4. During a patient’s day, there aren’t any patient’s handoffs. _______
5. It isn’t essential that people in hospitals work together as a team. _____
6. It is important for everyone to agree on minimal standards for information exchange. _______
7. The same essential information should be communicated during a handoff.______
8. Practitioners and staff often have had high formal training in handoff communication. ______ 9. Handoffs only occur at shift change. _____
Read and answer the following questions:
1. How many service handoffs take place every day in hospitals?
2. What have studies shown?
3. When do handoffs occur?
4. Why is information important during handoffs?
5. How practitioners and staff often learn handoffs communication?
6. Name four different examples of handoffs:
Vocabulary:
Match the following words with their definitions:
Caregivers_____
Goal ________
Increase_____
Achieve _______
Shift______
Deaf______
Inpatient______
Prioritize______
Definitions:
1. Physically unable to hear, or unable to hear well.
2. Someone whose job is to look after people. Someone who attends to the needs of a person.
3. Something that becomes bigger in amount, number or degree.
4. Someone who stays in hospital while they receive treatment.
5. To put several things in order of importance, so that you can do the most important first.
6. One of the periods during each day and night when workers in a factory, hospital, etc do their work.
7. To succeed in getting a good result or in doing something you want.
8. Something that you hope to achieve in the future.
Hundreds of service handoffs take place everyday when hospitalized patients are transferred between caregivers and units. Ideally, handoff transfer of patient care responsibilities occurs without a break in activities. A successful handoff avoids unwarranted changes in patient care goals, decisions, or plans, including dropping or reworking activities that others were told would be done by the previous caregiver. An increasing number of studies show that traditional methods of gathering patient data, organizing it, and communicating it among caregivers may not support high quality patient care. Practitioners must move beyond long-standing practices of information transfer (based on a one-way monologue) and toward a more effective system of information exchange (based on two-way dialogue).
Improving information exchange during service handoffs starts with clarifying the intent. What is considered a handoff and what are caregivers trying to achieve during these handoffs? Handoffs don’t only occur at shift change or at transition points (admission, transfer between units, discharge). During a patient’s day, there may be multiple patient handoffs – junior resident to senior resident, physician to nursing staff, surgery team to recover room staff, nurse to nurse handoffs. Common examples of potentially critical handoffs are shift changes for nursing staff and residents and transfer of patient care responsibilities from one physician to another or from one medical team to another, such as after a patient has had surgery and is transported to the post-anaesthesia recovery unit. Even seemingly routine handoffs, such as transport of an inpatient to the nuclear imaging department can be problematic if there is poor communication among caregivers. For instance, in one hospital an MRI technician described a situation in which she had particularly difficult time calming a patient during a test – only to find out later that the man was deaf. This vital information was never relayed to the technician when the patient was transported from the inpatient unit.
Don’t overlook handoff situations that involve other facilities or post-discharge caregivers, such as when patients are transferred to another hospital or discharged home for home care services. The transfer of inpatient care by a hospitalist to outpatient care by the patient’s primary physician is another example of a potentially critical handoff.
Ask caregivers involved in each type of handoff to describe what is considered safe and effective transfer of information. Use the questions below as a starting point in this discussion. * Who is primarily responsible for ensuring satisfactory information exchange?* What key communication steps need to be followed?* What minimal information needs to be communicated? * How should information be exchanged?* Who should be involved in this exchange?
It is essential that people work together as a team to identify the minimal set of information that needs to be imparted during the handoff and how best to accomplish the communication. With so many individuals involved in the care of patients, it is important for everyone to agree on minimal standards for information exchange. The communication mechanism may vary from unit to unit or situation to situation, however the same essential information should be communicated during a handoff. The specific information will vary according to the situation.
Whatever process changes are made to improve exchange of information during patient handoffs, caregiver training in communication techniques is also important. Safe and effective handoff communications depend on the ability of caregivers to prioritize relevant information and transfer insights effectively. Practitioners and staff often have had no formal training in handoff communication; it is often just learned on the job. No matter how efficient the handoff process becomes, the proper information exchange won’t take place if people don’t have the right communication skills.
Taken from: http://www.brownspath.com/original_articles/improvpatho.htm
Exercise:
Read the article “Improving patient handoffs” and decide if the following statements are true or false:
1. Only few handoffs take place every day in hospitals. _______
2. A successful handoff avoids unwarranted changes in patient care goal._____
3. An increasing number of studies show that traditional methods of gathering patients data, organizing it, and communicating it among caregivers support high quality patient care. _____
4. During a patient’s day, there aren’t any patient’s handoffs. _______
5. It isn’t essential that people in hospitals work together as a team. _____
6. It is important for everyone to agree on minimal standards for information exchange. _______
7. The same essential information should be communicated during a handoff.______
8. Practitioners and staff often have had high formal training in handoff communication. ______ 9. Handoffs only occur at shift change. _____
Read and answer the following questions:
1. How many service handoffs take place every day in hospitals?
2. What have studies shown?
3. When do handoffs occur?
4. Why is information important during handoffs?
5. How practitioners and staff often learn handoffs communication?
6. Name four different examples of handoffs:
Vocabulary:
Match the following words with their definitions:
Caregivers_____
Goal ________
Increase_____
Achieve _______
Shift______
Deaf______
Inpatient______
Prioritize______
Definitions:
1. Physically unable to hear, or unable to hear well.
2. Someone whose job is to look after people. Someone who attends to the needs of a person.
3. Something that becomes bigger in amount, number or degree.
4. Someone who stays in hospital while they receive treatment.
5. To put several things in order of importance, so that you can do the most important first.
6. One of the periods during each day and night when workers in a factory, hospital, etc do their work.
7. To succeed in getting a good result or in doing something you want.
8. Something that you hope to achieve in the future.
Efforts to Improve Health Care Quality
Improving health care quality is a team effort, and it is ongoing on many levels. To succeed, every part of the health care system must become involved, including government and nongovernmental organizations, doctors, nurses, pharmacists, hospitals, other providers, and you, the patient.
Sarah's Story
Sarah can tell you a story about the importance of getting good quality health care. Last year, she decided to have elective surgery to repair a hernia. She visited the surgeon in his office before the operation and was very pleased with his bedside manner and friendly staff. Sarah put herself in the doctor's hands and didn't ask many questions.
Although Sarah's operation went smoothly, she soon developed a high fever from an infection. The doctor said she would have to stay in the hospital a few extra days. That's when things began to go wrong. When she really needed them, the nurses were slow to respond to her calls, her doctor didn't always stop in to see her during his hospital rounds, and she sometimes didn't get her pain medicine on time.
Fortunately, Sarah's infection finally cleared up, and she was sent home to recuperate from her surgery. Sarah is fine now, but this story could have had a very different ending. If you need surgery, be sure to ask your doctor about the risks and benefits of the operation.
Select for examples of questions to ask your doctor.
One way to assess and track quality of care is by using measures that are based on the latest scientific evidence. A health care measure clearly defines which health care services should be provided to patients who have or are at risk for certain conditions. Measures also set standards for screening, immunizations, and other preventive care.
There are two types of measures: clinical measures and consumer ratings. Select for more information about health care quality measures.
Because measures are intended to set general standards for a broad population, they may or may not apply to you. Always check with your doctor about your level of risk for a particular condition and which types of screening and tests you should have.
Taken from: http://www.ahrq.gov/consumer/guidetoq/guidetoq5.htm
Sarah's Story
Sarah can tell you a story about the importance of getting good quality health care. Last year, she decided to have elective surgery to repair a hernia. She visited the surgeon in his office before the operation and was very pleased with his bedside manner and friendly staff. Sarah put herself in the doctor's hands and didn't ask many questions.
Although Sarah's operation went smoothly, she soon developed a high fever from an infection. The doctor said she would have to stay in the hospital a few extra days. That's when things began to go wrong. When she really needed them, the nurses were slow to respond to her calls, her doctor didn't always stop in to see her during his hospital rounds, and she sometimes didn't get her pain medicine on time.
Fortunately, Sarah's infection finally cleared up, and she was sent home to recuperate from her surgery. Sarah is fine now, but this story could have had a very different ending. If you need surgery, be sure to ask your doctor about the risks and benefits of the operation.
Select for examples of questions to ask your doctor.
One way to assess and track quality of care is by using measures that are based on the latest scientific evidence. A health care measure clearly defines which health care services should be provided to patients who have or are at risk for certain conditions. Measures also set standards for screening, immunizations, and other preventive care.
There are two types of measures: clinical measures and consumer ratings. Select for more information about health care quality measures.
Because measures are intended to set general standards for a broad population, they may or may not apply to you. Always check with your doctor about your level of risk for a particular condition and which types of screening and tests you should have.
Taken from: http://www.ahrq.gov/consumer/guidetoq/guidetoq5.htm
Exercise:
Read the article “Efforts to improve health care quality” and answer the folloing questions:
1. Who is in charge to improve health care quality?
2. Why did Sarah decide to have elective surgery?
3. Did she visit the surgeon before the operation?
4. Did she ask her doctor about the risks and benefits of the operation?
5. Why did she develop a high fever after the operation?
6. Were the nurses fast to respond to her calls?
7. Did she always get the pain medicine on time?
Observe the underline words in Sarah’s story (his, her…) and decide what they refer to:
She (line two)
His (line three)
Herself (line four)
Them (line seven)
Her (line seven)
His (line eight)
This (line eleven)
Answer true or false to the following sentences:
1. You don’t need to check with your doctor about the risk level for a particular condition. _____
2. There are four types of measures: home measures, consumer risk, clinical statistics and patient’s health. _____
3. One way to assess and track quality of care is by using measures that are based on the latest scientific evidence. _____
4. Measures set standards for screening, immunizations, and other preventive care. ________
5. Sarah didn’t have any problems during her surgery and everything was great after it. ______
Vocabulary:
Match the following words with their definitions:
1. Succeed _______
2. Surgeon_______
3. Bedside_____
4. Staff______
5. Wrong_____
6. Risk ______
Definitions:
a. The opposite of right.
b. A possibility that something bad or dangerous may happen.
c. To have the result or effect that was intended.
d. The area around a bed.
e. The group of people who work for an organization.
f. A doctor who does operations in a hospital.
Read the article “Efforts to improve health care quality” and answer the folloing questions:
1. Who is in charge to improve health care quality?
2. Why did Sarah decide to have elective surgery?
3. Did she visit the surgeon before the operation?
4. Did she ask her doctor about the risks and benefits of the operation?
5. Why did she develop a high fever after the operation?
6. Were the nurses fast to respond to her calls?
7. Did she always get the pain medicine on time?
Observe the underline words in Sarah’s story (his, her…) and decide what they refer to:
She (line two)
His (line three)
Herself (line four)
Them (line seven)
Her (line seven)
His (line eight)
This (line eleven)
Answer true or false to the following sentences:
1. You don’t need to check with your doctor about the risk level for a particular condition. _____
2. There are four types of measures: home measures, consumer risk, clinical statistics and patient’s health. _____
3. One way to assess and track quality of care is by using measures that are based on the latest scientific evidence. _____
4. Measures set standards for screening, immunizations, and other preventive care. ________
5. Sarah didn’t have any problems during her surgery and everything was great after it. ______
Vocabulary:
Match the following words with their definitions:
1. Succeed _______
2. Surgeon_______
3. Bedside_____
4. Staff______
5. Wrong_____
6. Risk ______
Definitions:
a. The opposite of right.
b. A possibility that something bad or dangerous may happen.
c. To have the result or effect that was intended.
d. The area around a bed.
e. The group of people who work for an organization.
f. A doctor who does operations in a hospital.
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