Overlapping emergency room shifts reduced patient handoffs

To boost patient safety and physician efficiency, Seattle Children's Hospital adopted overlapping emergency room shifts for physicians and achieved a dramatic reduction in patient handoffs, recent research shows.

"A total of 43,835 patient encounters were analyzed. Immediately after implementation of the new model, there was a 25% reduction in the proportion of encounters with patient handoffs, from 7.9% to 5.9%," the researchers wrote in the Annals of Emergency Medicine.

Patient handoffs bear high risk for compromised patient safety. An earlier study of ER shift-change handoffs showed that vital signs were not communicated for as many as 74% of patients, and another study showed errors or omissions occurred in 58% of handoffs.

Hiromi Yoshida, MD, MBA, the lead author of the research, said the waterfall staffing model generates several efficiency gains, including:

• Fewer handoffs ease the cognitive workload from interruptions and interactions in busy ERs. "It has been shown that excessive cognitive workload and increased stress negatively affect performance," he said.
• With incoming physicians jumping into treating patients instead of spending time receiving handoffs, patient care is not delayed.
• The waterfall model ensures that a rested and refreshed physician is coming in at staggered times, which provides relief for the staff that has already been in the ED for several hours.

Source: HealthLeaders