October 24, 2013

New process for patient handovers from ED to units

Beginning Oct. 29, Vanderbilt University Hospital will use a new process for patient handovers between nurses in the adult Emergency Department and nurses on inpatient units.

Beginning Oct. 29, Vanderbilt University Hospital will use a new process for patient handovers between nurses in the adult Emergency Department and nurses on inpatient units.

“The new process will aid both patient safety and more efficient patient flow and bed management,” said Apryl Steele, R.N., a clinical staff leader in the ED.

The centerpiece of the new process is a consistently thorough nurse-to-nurse phone conversation, for every patient headed from the ED to any unit of VUH, covering information needed for a safe, efficient nursing handover.

“Developing a standardized process for handover is key to improving patient transitions between various silos within the hospital. The new ED-to-VUH nursing handover will improve patient care and staff satisfaction, and is part of larger efforts to improve patient flow at the hospital level,” said Elizabeth McClanahan, operations director of the Patient Flow Center.

The phone call will happen approximately 20 minutes after the patient’s VUH bed assignment is made. This 20-minute interval is intended to give receiving nurses in VUH a chance to review the patient’s electronic record before the handover.

Currently, receiving nurses on many floors of VUH receive faxed nursing handover forms, which have been completed by hand by ED nurses. Faxed handovers will end on Oct. 29.

The electronic whiteboard displayed throughout the ED will alert nurses to each impending handover. The moment the patient’s bed assignment is posted, the whiteboard will launch a 20-minute handover countdown, with the patient’s handover field (denoted by a schematic image of a telephone) turning red after 20 minutes. The ED nurse’s final step is to document that the handover occurred.

The new handover was designed with the assistance of ED and inpatient nurses and was piloted on hospital units 8 North, 8 South, 9 North and 9 South.

For more information contact Laura Hollis, MSN, R.N., at laura.hollis@Vanderbilt.Edu.