Handoff standardization in the neonatal intensive care unit with an EMR-based handoff tool

This quality improvement project aimed to improve the accuracy and efficiency of handoff communication among NICU medical providers with an Electronic Medical Record (EMR)-based handoff tool (HT).

Three Plan-Do-Study-Act (PDSA) cycles were utilized following the implementation of a NICU-specific EMR-based HT and a standardized handoff process. Primary measures included accuracy of demographic components: patient name, bed, age, gestational age, postmenstrual age; and medical components: active diagnoses, weight, vascular access, respiratory support, diet, total fluid goal, medications. Secondary measures included environmental components (start time, duration, location, and distractions) as indicators of efficiency.

Accuracy of handoff components improved from 68% to 99% (p < 0.001). Efficiency of the handoff improved with time needed to complete patient handoff decreasing from 78 to 47 s per patient (p < 0.001).

Standardizing the NICU handoff process using an EMR-based HT allowed for increased accuracy of handoff components and improved efficiency, which may promote enhanced patient safety.