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Design to Implementation Study for Development and Patient Validation of Paper-Based Toehold Switch Diagnostics
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Implementing electronic handover: interventions to improve efficiency, safety and sustainability.

Sharifah Munirah Alhamid1, Desmond Xue-Yuan Lee2, Hei Man Wong1

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Implementing electronic handover tools in hospitals requires end-user collaboration and leadership support. A combined approach improved compliance and ensured the safe, sustained use of electronic medical records (EMRs) for patient care.

Keywords:
electronic handoverpatient handoverspatient safetyquality improvement

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Area of Science:

  • Healthcare Informatics
  • Clinical Workflow Optimization
  • Patient Safety Research

Background:

  • Effective patient handovers are vital for safe and efficient healthcare delivery.
  • Electronic handover tools aim to standardize information exchange but face implementation challenges.
  • Previous attempts at electronic handover tool adoption in tertiary hospitals were hindered by low end-user compliance and buy-in.

Purpose of the Study:

  • To address challenges in implementing a new electronic handover tool integrated with electronic medical records (EMRs) at Singapore General Hospital (SGH).
  • To improve compliance and adherence to safety rules for an electronic handover system.
  • To ensure the safe and sustained use of the electronic handover tool.

Main Methods:

  • A quality improvement initiative employed rapid Plan-Do-Study-Act (PDSA) cycles involving end-users and stakeholders.
  • Multi-faceted interventions, including media and online software solutions, were developed to enhance compliance.
  • Key outcome measures included the percentage of unacknowledged handovers and assessments of doctors' knowledge and perceptions.

Main Results:

  • The study successfully reduced the percentage of unacknowledged daily handovers through iterative PDSA cycles.
  • Interventions led to improved doctor compliance with electronic handover procedures.
  • Doctors showed enhanced understanding of safety rules and a more positive perception of the electronic handover tool.

Conclusions:

  • Successful implementation of electronic handover tools necessitates close collaboration between end-users and senior leadership.
  • A hybrid 'bottom-up' and 'top-down' strategy, coupled with continuous process evaluation, is essential for long-term sustainability.
  • Electronic handover tools can effectively complement clinical practice when implemented thoughtfully.