As an information system, the EHR has a longer history supporting administrative tasks than supporting clinical care. Seamlessly delivering information into the proper clinical context during the work of a healthcare provider is important for quality, safety and efficiency.Read More
Question Does the UW-IPASS standardized handoff affect clinician communication in the intensive care unit?
Findings In this single-institution cluster randomized stepped-wedge clinical trial, the use of a standardized handoff curriculum resulted in a significant 3% decrease in communication errors, without any change in the duration of the handoff. Seventy-three percent of clinicians reported that participation in the curriculum improved team communication and patient safety.
Meaning The IPASS-based transitions of care represent an important step forward in communication standardization efforts and may help reduce clinician communication errors and omissions.Read More
Purpose. To determine whether changing sign-out practices and decreasing the time spent in rounding and recopying patient data affect patient safety. Responding to limited resident duty hours, the University of Washington launched a computerized rounding and sign-out system (“UW Cores”). The system shortened duty hours by facilitating signout, decreasing rounding time, and sharply reducing the time spent in prerounds data recopying.Read More
Background. Hospital-based clinicians and educators face a difficult challenge trying to simultaneously improve measurable quality, educate residents in line with ACGME core competencies, while also attending to fiscal concerns such as hospital length of stay (LOS).
Background. Adoption of limits on resident work hours prompted us to develop a centralized, Web-based computerized rounding and sign-out system (UWCores) that securely stores sign-out information; automatically downloads patient data (vital signs, laboratories); and prints them to rounding, sign-out, and progress note templates. We tested the hypothesis that this tool would positively impact continuity of care and resident workflow by improving team communication involving patient handovers and streamlining inefficiencies, such as hand-copying patient data during work before rounds (“prerounds”).Read More
Background. The problem of safe and efficient transfer of care has increased over the years as new and complex diagnostic tools and more complex treatment options became available. Traditionally, residents ensured continuity of care by working long hours and minimizing the transfer of significant diagnostic or therapeutic responsibilities to other providers. The new 80-hour workweek has curtailed that practice and increased the pressure on trainees for workflow efficiency. We report on a study of informationhandling routines among residents for the separate tasks of transfer of care (‘‘sign-out’’) and daily patient care work (ward work). Using these results, an institution-wide computerized system was developed to centralize information-handling tasks and facilitate the management and transfer of patient care information.Read More