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What are some strategies to help monitor the effectiveness of patient hand-offs during my nurses’ change-of shifts?

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We traditionally think of compliance monitoring in terms of doing audits of medical records. We are programmed early in our healthcare careers to look for documentation. Although that is important if your hand-off process requires a form, it is more important at the onset to physically listen and observe the hand-off process in action. Doing so will enable you to make a qualitative assessment of how well your process is working:

  • Talk with the staff to make sure they understand the value of the hand-off process and that they give it the time and energy it deserves
  • Talk with staff going off shift to see how they identified the most pertinent facts to relate and see if, upon review, it really was the most pertinent
  • Talk with the receiving staff at the end of their shifts to see whether the information they received at the hand-off was indeed useful and meaningful for the work they had to do with that patient

Try to evaluate the hand-off process qualitatively. Also, evaluate staff perceptions about the hand-off process. Do they feel that they have the time, tools, training, and skills to implement the process effectively as designed? If the staff feedback is negative at the onset, try to refine or streamline the process.

-- Kurt Patton, MS, RPh

(December 2009)