Improving Patient Handoffs: A Literature Review

This assignment tasks you with critically evaluating a collection of research articles focused on enhancing patient handoff communication within healthcare environments. The goal is to analyze the various strategies proposed by these studies and their impact on patient safety, workflow efficiency, and overall care quality. You'll need to synthesize the findings from these articles to present a comprehensive understanding of current best practices and future directions in improving patient handoffs.

Running Head: PRACTICUM PROJECT PROPOSAL 1
Practicum Project Proposal:
Hands-off Statement in Precarious Care Unit
Author’s Name
Institutional Affiliation

PRACTICUM PROJECT PROPOSAL 2
Hands-off Statement in Precarious Care Unit
Handoff communication in nursing can be defined as the joint communication in National
Patient Safety Goals aimed at helping correct the medical errors which may occur due to
miscommunication in the invents of transfers and handoffs. The project initiated in 2006 in the
United States of America. and the purpose of this research paper is to investigate how hand-off
communication through the joint commission in NPSG helps to ensure critical health care for
patients in the hospital delivered. Therefore, the goal of this research proposal is to examine how
JCI has helped to improve patient safety through hand-off communication strategy. For example,
the attention given to the handoff communication by World Health Organization and Common
Wealth Fund has helped to improve the safety of the patient. Additionally, this paper examines
the High 5's project created through the collaboration of the WHO together with Common
Wealth Fund helps in the creation of a solution to the five communication-based problems, one
being the handoff communication (Bigham et al., 2014).
Moreover, other four communication-based problem includes wrong surgeries, hand
hygiene, continuous medical errors as well as the high medical error concentration. Through
research of different hospital, the paper will seek to come up with preventive solutions as well as
strategies. Later on, the knowledge from the research paper can be shared with other countries to
help improve their health care centers. The paper will adopt joint communication format. The
form includes an objective statement which is crucial when choosing the international patient
safety goals dedicated to handoff communication.
Goal statement

PRACTICUM PROJECT PROPOSAL 3
. Therefore, the proposal strives to ensure that severe injuries, as well as unexpected
patient death caused by poor communication, are reduced. Moreoverthe research focuses on the
all healthcare and service delivery. This health centers includepatient movement from one
location to another around the hospital, information transfer and shift to shift handoff within the
same unit (Abraham et al., 2017 p 144).
Consequently, the growing body of literature indicates that a bigger population
worldwide is being affected by the poor handoff communication taking place within the hospital.
The research paper targets approximately 200 health workers found in different hospitals within
Australia. Additionally, the propels aims at reaching close to 700 patients discovered in the
hospital as well as those suffering in their residential areas (Feraco et al., 2016, p 531).
Project Objective
As a result of the problems cited earlier, this paper pursues to address different ways in how
the implementation of handoff communication contributes in helping the government,
organization as well as health workers and other international agencies concerned with the fight
for patient safety through effective implementation of handoff communication in various
hospitals. The objective of this research can be categorized as follows
 To develop as well as implement an operative handoff communication plan and policy
 To ensure that there is effective communication through implementation and utilization
of check back methods or technologies

PRACTICUM PROJECT PROPOSAL 4
 To come up with technology to enhance communication. For example, timely as well as
efficient transmission of patient data can be easily supported by electronic methods of
communication.
Additionally, to ensure that there is the adequate completion of the project, the research seeks
to come up with the following steps.
Finding patient transition points
Understanding all the physical as well as informational handoffs available within the area
of practice such as duration where any two members of team exchange information concerning
the patient.
Understanding present handoff process
For practical completion of the projects, a better understanding of the various types of
transition that is currently occurring is vital. For example, the handoff process to be determined
includes who the sender is, what the recipient will receive and many other activities (Starmer et
al., 2017).
Understanding the present workflow
Everyone involved in the transition must have a well-defined workflow. Formal mapping
process can be one of the best ways to be used to map the workflow process. Informal mapping
process; observation is done for each worker during the entire workday or a portion of the
workday. During the remark, a record should be done on what the worker has done, where they
had done it as well as when they did it.

PRACTICUM PROJECT PROPOSAL 5
Establishing new workflows
After analyzing the current workflows, propose a new operator that can suit all the
members including the team members affected with the previous workflow. After reaching n
agreement with all the staff, establish the new workflows.
Coming up with solutions to various barriers
After identification of different transition points, the research pursues to come up with
solutions that ensure that patient engagement as well as safety. For example, the study proposes
that the staff member whose room hosted the patient should hand-off the patient to the clinician
in person with the patient present. Therefore, the patient can clarify the information that the
clinician gets from the team members in charge of the patient (Di Delupis et al., 2014, p 582).
Evidence-based Literature Reviews
According to Benjamin et al. (2016), handoffs have created distinct and significant
communication gaps, errors and omission gaps regarding patient care. In fact, the author is
advocating for computerization of the communication handoff in patient care as a prompt
measure to assist hospital to curb the emerging problems. This study also provides conclusive
information which shows that verbal handoff plays a significant role and thus, serves not only as
information transfer source but also forms the basis functions in the healthcare provision.
Despite, the importance of handoff healthcare program in the hospitals, there is inadequate
research and patient-centered information on how to implement the plan successfully.

PRACTICUM PROJECT PROPOSAL 6
Handoff communication also gives absolute control and responsibility whenever a
transfer occurs in the critical health care docket. Therefore, handoff health care will assist in
decision-making situations even with little alteration of the information. This will help in
minimizing time-consuming as well as reduces instances which might lead to adverse
consequences. Handoff communication entails transfer situation and strong adherence to the
legal responsibility which nurses and physicians must tackle in their line of duty (Colvin et al.,
2016, February).
According to Patton et al. (2017, p 52), patient handoffs entails transferring of the
medical healthcare provisions from one provider to the other. Both Poor quality and incomplete
patients’ handoffs are some of the adverse implications which are encountered in the healthcare
field. Thus, standardization of the process is essential to increase and improve care transitions of
the patients. The first implementation program for the handoff proposal was brought into action
by Joint Commission's National Patient Safety through the use of standardized methodology, and
this took place in 2006. However, the introduction of the standardized approach has resulted in
advance complications which include fatigue and thus, has led to increased unintended
consequences witnessed among patients.
Furthermore, there are different patient handoffs types which are used in critical
healthcare unit. For instance, there is the use of handoffs in the either recovery or ICU ward as
well as the application of the technique in the recovery ward by the surgeons. Nevertheless,
different checklists can cover the handoffs but not limited to the surgical subspecialty. This
literature, therefore, shows that there is lack of proper tool or checklist made approvals which

PRACTICUM PROJECT PROPOSAL 7
can be used for transferring the residents while the patients are in the recovery. Therefore, the
literature encourages the use of face-to-face and verbal handoffs (Abraham et al., 2014, p 202).
Lack of proper standardization in the BHW nursing is a major limitation which affects
the handoff process in the healthcare. In recent days, the shift in the handoff communication has
resulted into three key methodologies and these which include verbal, written reports as well as
taped. However, there is a limitation in dealing with the handoff dataset since the policy
department in the nursing sector hasn’t established a standard mechanism of compiling the
information. Thus, lack of proper mechanism has increased handoff errors in different areas and
hence risking the safety of patients (Clarke et al., 2017, p 875).
Methodology
Examining and appraising the project, it is important to employ two key techniques
which include primary and secondary methods. In essence, all the changes regarding the
information omissions will be evaluated for one month. The one-month period will also cater for
the post-intervention measures, and it will be determined using direct observation method.
Additionally, it is important to examine the teamwork score, and this will be done using
quantitative analysis which will include interviews and administered questionnaires. The
quantitative should be conducted in the intensive care unit and must be done after the
implementation of the intervention and should take one month. Also, the post-intervention
analysis should take one month, and the process mainly aims at evaluating the changes in the
length of stay of patients. Furthermore, the process should be conducted in the hospital and the
intensive care unit during the post-intervention period. Finally, it is important to evaluate

PRACTICUM PROJECT PROPOSAL 8
qualitative implementation outcomes changes to assess and ascertain appropriateness,
acceptability, and fidelity of the result and should be done in one month (Gagnier et al. 2016,p
370).
Resources
It is important to establish different resources which one will need for the project. Some
of the resources include human-ship who will assist in data collection; also it is essential to work
on an intensive care unit which will be used for pre and post-intervention analysis. Furthermore,
it is important to embark on literature research using, “The Joint Commission’s Web site
(Vanderbilt et al., 2017).”
Formative Evaluation
Evaluating the progress of the project using formative evaluation is important. In the
process, it will be important to examine the techniques for qualitative and quantitative
approaches of compiling data as well as literature reviews. This will be conducted after one
month once the critical healthcare project kicks off (Benjamin et al., 2016).
Summative Evaluation
The summative evaluation will be carried out once the data collected and mathematical
statistics are compiled. It involves reporting the means as well as percentage scores of the pre-
and post-implementation pilot studies. The process will also include giving qualitative feedback
of the patients, and this dataset must be grouped thematically. Therefore, handoff communication

PRACTICUM PROJECT PROPOSAL 9
timeframe will be estimated using linear regression modeling, and this ensures that there is
control in the number of patients at each handoff stage (Quinn et al., 2016).
Project Timeline
Task Name Start End
Duration
(days)
Task 1 Project Introduction 08-28-17 08-28-17 1
Task 2 Goal statement 08-29-17 08-29-17 1
Task 3 Project Objective 09-02-17 09-03-17 2
Task 4 Evidence-based
Literature Reviews 09-06-17 09-09-17 4
Task 5 Methodology 09-10-17 09-16-17 7
Task 6 Resource 08-028-17 09-28-17 15
Task 7 Formative Evaluation 09-17-17 05-18-17 2
Task 8 Summative Evaluation 09-19-17 09-20-17 2

PRACTICUM PROJECT PROPOSAL 10
References
Abraham, J., Kannampallil, T. G., & Patel, V. L. (2014, June). Towards an ontology for
interdisciplinary handoff communication in intensive care: implications for tool
resiliency and patient safety. In Proceedings of the International Symposium on Human
Factors and Ergonomics in Health Care(Vol. 3, No. 1, pp. 196-202). Sage India: New
Delhi, India: SAGE Publications.
Abraham, J., Kannampallil, T. G., Srinivasan, V., Galanter, W. L., Tagney, G., & Cohen, T.
(2017). Measuring content overlap during handoff communication using distributional
semantics: An exploratory study. Journal of biomedical informatics, 65, 132-144.
Benjamin, M. F., Hargrave, S., & Nether, K. (2016). Using the Targeted Solutions Tool® to
Improve Emergency Department Handoffs in a Community Hospital. The Joint
Commission Journal on Quality and Patient Safety, 42(3), 107-AP4.
Benjamin, M. F., Hargrave, S., & Nether, K. (2016). Using the Targeted Solutions Tool® to
Improve Emergency Department Handoffs in a Community Hospital. The Joint
Commission Journal on Quality and Patient Safety, 42(3), 107-AP4.
Bigham, M. T., Logsdon, T. R., Manicone, P. E., Landrigan, C. P., Hayes, L. W., Randall, K. H.,
... & Williams, C. I. (2014). Decreasing handoff-related care failures in children’s
hospitals. Pediatrics, 134(2), e572-e579.
Clarke, C. N., Patel, S. H., Day, R. W., George, S., Sweeney, C., De Oca, G. A. M., ... &
Bodurka, D. C. (2017). Implementation of a standardized electronic tool improves

PRACTICUM PROJECT PROPOSAL 11
compliance, accuracy, and efficiency of trainee-to-trainee patient care handoffs after
complex general surgical oncology procedures. Surgery, 161(3), 869-875.
Colvin, M. O., Eisen, L. A., & Gong, M. N. (2016, February). Improving the patient handoff
process in the intensive care unit: Keys to reducing errors and improving outcomes.
In Seminars in respiratory and critical care medicine(Vol. 37, No. 01, pp. 096-106).
Thieme Medical Publishers.
Di Delupis, F. D., Pisanelli, P., Di Luccio, G., Kennedy, M., Tellini, S., Nenci, N., ... & Gensini,
G. F. (2014). Communication during handover in the pre-hospital/hospital interface in
Italy: from evaluation to implementation of multidisciplinary training through high-
fidelity simulation. Internal and emergency medicine, 9(5), 575-582.
Feraco, A. M., Starmer, A. J., Sectish, T. C., Spector, N. D., West, D. C., & Landrigan, C. P.
(2016). Reliability of Verbal Handoff Assessment and Handoff Quality Before and After
Implementation of a Resident Handoff Bundle. Academic pediatrics, 16(6), 524-531.
Gagnier, J. J., Derosier, J. M., Maratt, J. D., Hake, M. E., & Bagian, J. P. (2016). Development,
implementation and evaluation of a patient handoff tool to improve safety in orthopaedic
surgery. International Journal for Quality in Health Care, 28(3), 363-370.
Patton, L. J., Tidwell, J. D., Falder-Saeed, K. L., Young, V. B., Lewis, B. D., & Binder, J. F.
(2017). Ensuring safe transfer of pediatric patients: A quality improvement project to
standardize handoff communication. Journal of Pediatric Nursing, 34, 44-52.

PRACTICUM PROJECT PROPOSAL 12
Quinn, M., Alsop, S., Velasquez, T., Bodinet, A., Smith, M., & Flood, S. (2016). Introduction of
“Comfort Card” In Perioperative Area to Improve Patient Experience and Nursing
Communication. Journal of PeriAnesthesia Nursing, 31(4), e3-e4.
Starmer, A. J., Schnock, K. O., Lyons, A., Hehn, R. S., Graham, D. A., Keohane, C., &
Landrigan, C. P. (2017). Effects of the I-PASS Nursing Handoff Bundle on
communication quality and workflow. BMJ Qual Saf, bmjqs-2016.
Vanderbilt, A. A., Pappada, S. M., Stein, H., Harper, D., & Papadimos, T. J. (2017). Increasing
patient safety with neonates via handoff communication during delivery: a call for
interprofessional health care team training across GME and CME. Advances in medical
education and practice, 8, 365.
Appendix
Duration (days)
0 2 4 6 8 10 12 14 16
Task 8 Summative
Evaluation
Task 7 Formative
Evaluation
Task 6 Resource
Task 5 Methodology
Task 4 Evidence-based
Literature Reviews
Task 3 Project Objective
Task 2 Goal statement
Task 1 Project Introduction
Task Name Start End