Improving handoff efficiency from emergency department to intensive care

Abstract

The emergency department to intensive care unit nurse handoff process was found to be inefficient in a Midwest community hospital, resulting in prolonged admission times. The purpose of this project was to determine if implementation of a standardized bedside nurse handoff process would affect admission efficiency. Efficiency of nurse handoff, efficiency of emergency department to intensive care unit admissions, and rates of intensive care unit patient boarding in the emergency department were examined. A task force composed of staff nurses developed a standardized bedside nurse handoff process following guidelines from the literature. This new handoff process incorporated the evidence-based concepts of bedside report, standardization, and electronic medical record. Stakeholder and staff buy-in were obtained, and the process was implemented. Outcomes were evaluated six months prior to- and one-year post-implementation of the standardized bedside handoff process. Analysis of one-year post-implementation data revealed an improvement in average handoff time by 15 minutes, an improvement in average admission time by 17 minutes, and a reduction in intensive care unit patient boarding by 19.5%. By improving efficiency of the nurse handoff process, and therefore the admission process, the findings of this project have the potential to reduce patient boarding and improve the quality of patient care. This quality improvement project also contributes to a gap in the current body of evidence pertaining to interdepartmental nurse handoffs.