other mother
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Patient Care Hand OffPassing the Torchwithout Passing the Buck!
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“You are the ones who are going to be caring for the ones that I love”
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WHODoctors
Nurses
Paramedics
EMTs
Allied Health This information has been brought to you by
WHEREFirst Response to Ambulance
Ambulance to Paramedic
Paramedic to ED
ED to Interventional Staff
Interventional Staff to Critical Care Staff
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Hand-offs involve the transfer of [patient care information,] rights, duties and obligations from one person or team to another.
WHAT
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Hand Off
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Problem
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Common Medical Errors
http://www.flickr.com/photos/meganpatapoff/6545674775/lightbox/The Source Of
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“TheBermudaTriangleof
Healthcare”
PatientHandOff
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Patient Care Hand-Off Communications have been identified as a critical safety and quality problem.
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In 2005, this increased to 70%, with
50%during the hand-off.
– The Joint Commission. Improving handoff communicati ons: Meeti ng Nati onal Pati ent Safety Goal 2 E. Joint Perspect Pati ent Safety . 2006;6:9-15.
More than 3,000 sentinel events from 1995 to 2004 revealed
65% of reported problems caused by
poor communication.
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3 AM
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Delay in treatment
Inappropriate treatment
Adverse events
Omission of care
Increased hospital length of stay
Avoidable readmissions
Increased costs
Inefficiency from rework
Other minor or major patient harm.
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Can I get a Witness?•None•One•Some•All
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Resources
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GeneralCulture: Lack of teamwork and respect
Expectations between sender and receiver differ
Ineffective communication method, e.g. verbal, recorded, bedside, written
Timing of physical transfer of the patient and the hand-off are not in sync
Inadequate amount of time provided for successful hand-off
Interruptions occur during hand-off
Lack of standardized procedures in conducting successful hand-off
Inadequate staffing to accommodate successful hand-off
Patient not included during hand-off
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SendingSender provides inaccurate or incomplete information, e.g. medication list, DNR, concerns/ issues, contact information
Sender, who has little knowledge of patient, is handing off patient to receiver
Sender unable to provide up-to-date information, e.g. lab tests, radiology reports, because not available at the time of hand-off
Inability of sender to follow up with receiver if additional information needs to be shared
Sender asked to repeat information that has already been shared This information has been brought to you by
ReceivingReceiver has competing priorities and is unable to focus on
transferred patient
Receiver unaware of patient transfer
Inability for receiver to follow up with sender if additional information is needed
Lack of responsiveness by receiver
Receiver has little knowledge of patient being transferred This information has been brought to you by
Resources
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4 AM
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Problem
OpportunityOpportunity
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Alerts Glasgow Coma Scale GCS
Face Arm Speech Time ER FASTER
Boston Operation Stroke Scale BOSS
Cincinnati Prehospital Stroke Scale CPSS
Melbourne Ambulance Stroke Screen MASS
Age, Blood Pressure, Clinical Features, Duration Score ABCD
Brooklyn Stroke Scale BSS
Los Angeles Prehospital Stroke Screen LAPSS
Miami Emergency Neurological Deficit Checklist MEND
National Institute of Health Stroke Scale NIHSS
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When EMS provided hospital staff with advanced notification of incoming stroke patients, the number of patients eligible for thrombolytic therapy significantly improved.
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Systematic Approach
Situation
Background
Assessment
Recommendations This information has been brought to you by
Slow is SmoothABC’s
Moment of Silence
Echo Answer
Smooth is FastThis information has been brought to you by
Add a Q
Questions
Quantify
Qlarify This information has been brought to you by
Opportunity
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In A World
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In A World
Reduce errors!
Facilitate the continuum of care!
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SHAREStandardize
Hardwire
Allow Questions
Reinforce
Educate & CoachThis information has been brought to you by
Handoff communication is… a dialogue between health professionals…that fosters empathy, equity, common ground, in addition to transferring necessary information.
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Patient Care
www.other-mother.in
https://www.facebook.com/pages/Other-Mother-Nursing-Crusade/224235031114989
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