Miscommunication is a leading cause of medical error and despite efforts to improve communication, the level of incidents remains high. In fact, recent information from the Agency for Healthcare Research and Quality found that communication breakdowns during handoffs contribute to approximately 70 percent of deaths caused by medical error in hospitals and healthcare organizations.
But with the help of web and cloud-based tools, some hospitals are managing to cut communication errors that occur during patient handoffs by nearly one-third, saving countless lives and millions in cost avoidance.
According to a study which includes the results of the technology’s integration into multiple hospitals, centers such as Boston Children’s saw a 30 percent reduction in preventable adverse events during patient handoffs by employing communication tools from the I-PASS Patient Safety Institute, which standardizes the patient handoff process during nurse shift changes.
“We found that implementation of the I-PASS Handoff Bundle across nine academic hospitals was associated with a 23% relative reduction in the rate of all medical errors and a 30% relative reduction in the rate of preventable adverse events. We also found significant decreases in rates of specific types of medical errors, including diagnostic errors,” the authors of the report note.
With the change, the study estimates that hospitals were able to save between $10 million to $20 million in three years by preventing adverse events. Moreover, the study concludes that the positive changes came without a negative impact on clinician workflow.
Clinical Communication Tools and Best Practices Go Hand in Hand
So how does it work? The I-PASS technology is made available through a tablet or embedded into the electronic health record system at a hospital and defines which information should be included in a patient handoff. It asks nurses to include information around “why the patient was hospitalized, patient condition, treatments given, what services need to be done and any other recommendations,” Health Data Management reports.
Cloud-based benchmarking software, which can be used on smartphones, tablets and desktop computers, then gives providers a way to assess the success of each handoff, Healthcare IT News reports.
When nurses or physicians tap on an element of a handoff, the software will summarize how effectively it was done and provide benchmarks for units throughout the hospital, William Floyd, president and CEO of the I-PASS Patient Safety Institute, tells the site.
"So, in the ICU it's being done at 70 percent, versus in surgery it's being done at 90 percent. You can benchmark across the hospital. And then you can also benchmark between hospitals: Mass General and Boston Medical Center can see how they are doing by comparison, and by care area,” Floyd tells the site.
Beyond the technology itself, the practice includes a verbal handoff note at the patient’s bedside from each nurse or physician handing the patient off to another care provider, who repeats the handoff information to ensure clarity and understanding.
“I-PASS is really a best practice in communication to ensure that no information gets missed during the handoff,” James Moses, a vice president and chief quality officer at Boston Medical, tells Health Data Management. After the hospital opted to employ the technology in July, Moses worked with leaders across the hospital’s various departments in order to achieve enterprisewide use of the technology and ensure that all staff fully adopted the technology and representations. His next steps include ensuring the standards and technology are used at all times.
“This is not just a lever or a button you can push or pull, but a journey to continuously improving patient handoffs,” he tells the source. “I-PASS helped us identify a strategy to provide feedback to clinicians through measuring of adherence and use to know which departments are doing well with I-PASS and in which areas the use rate is not so good, so we constantly know where our gaps are.”
Ultimately, through improved communication between clinicians, the technology helped to improve outcomes across several hospitals.
"The value of the I-PASS program is unquestionable in terms of improved patient care through reduction in medical errors," said Moses in a statement. "With the I-PASS Patient Safety Institute, we can continue to implement and sustain this important program in a fraction of the time we would spend doing it ourselves and with far fewer resources."