“We will find our baseline measurement using nurse surveys, audits and observation timings. We will track what steps are covered and how long each step takes and the number of occurrences of near misses due to inefficient handoffs relating to patient safety. We will also measure our patient baseline data from current patient satisfaction surveys” N. Guyse (personal communication, February 22, 2014). Currently we are inefficient and unsafe with handoff practices due to missing or incomplete information, multiple processes used between the nursing staff, and multiple report out processes being practiced on the floor. Multiple processes are causing confusion and incidental overtime. With multiple processes, information is being missed between nursing staff, which is a safety concern due to the increased errors. Our organization is working on the creation of one standardized process used between all employees to ensure that all handoffs are efficient and safe. “We have implemented a group report out for nursing staff in conjunction with the beside report outs” N. Guyse (personal communication, February 22, 2014).
Sample measures through patient and nurse satisfaction surveys and observations will be used to show if we are making improvements with the change. Run charts will be used to show if improvements are taking place over time and will help with improvements by depicting how well the handoff process is performing. They will help in determining when changes are truly improvements by displaying a pattern of data that we can observe as we make changes and give direction to our team. Workflow processes will also measure improvements that will show improvements with the process change.
A convenience sample of patients can be used to test the plan using a set number of patients to be surveyed before the process change and another survey completed after the implementation of the change. All nursing staff should also be encouraged to participate. A monthly survey with randomly selected patients, who received care, will be asked to take a survey to help track the progress of the change. Examples of survey items can include what to expect, staying informed, access care providers, and consistency of information from physicians and nurses. Patient satisfaction surveys are a qualitative approach that will be analyzed to understand perceptions of the patients and show if the organization is improving satisfaction due to the implementation of handoff changes. Nurses will also take a survey before and after the implementation of change to gather information on where we currently are with effective handoffs and their feelings after implementation of the change.
Beginning with a pilot can be a good way for the organization to start. This is a small trial of the proposed process or system, which can be tested within the departments or a specific group of patients involved in the process change. The pilot or trial can shed light on any barriers...