Increasing Compliance with a New Interunit Handoff Process: A Quality Improvement Project.

Area of Science:

• Nursing
• Quality Improvement
• Patient Safety

Background:

• Standardizing interunit patient handoff is crucial for improving communication, information transfer, and patient safety.
• Few studies have focused on enhancing staff compliance with newly implemented handoff procedures.
• Effective nurse handoff protocols are essential for continuity of care between units.

Purpose of the Study:

• To implement and evaluate a new nurse handoff process between the postanesthesia care unit and Medical/Surgical units.
• To increase staff compliance with the standardized handoff process through user input and on-the-job coaching.
• To achieve 100% staff compliance with the new handoff process within 90 days.

Main Methods:

• Involved frontline nursing staff in standardizing and modifying the handoff process during a 2-day workshop and 1.5-week pilot.
• Provided on-the-job coaching during the bedside trial of the new handoff process.
• Utilized three 30-day plan-do-study-act cycles, incorporating compliance observations and user feedback for iterative refinement.

Main Results:

• Observed a significant decrease in noncompliant process elements from 15% to 4% over the 90-day trial period.
• Maintained handoff duration without undesirable increases (mean 8.05 ± 4.72 minutes).
• Prevented several potential errors related to orders, charting, and patient placement through the new handoff process.

Conclusions:

• Incorporating user input into process design and providing on-the-job coaching effectively increased frontline staff compliance.
• The iterative refinement of the handoff process led to sustained improvements in adherence.
• This quality improvement project demonstrates a successful strategy for enhancing standardized nurse handoff compliance and patient safety.