From the Guidelines
To improve the transfer of patients to other units, implementing standardized handoff protocols like SBAR (Situation, Background, Assessment, Recommendation) is essential, as recommended by recent guidelines 1. This structured communication approach ensures critical information is consistently shared between healthcare providers. Developing a comprehensive transfer checklist that includes patient identification, medical history, current medications with dosages, recent vital signs, and care requirements helps prevent omissions of important details. Some key considerations for safe transfer include:
- Designating a transfer coordinator for each shift to streamline the process and ensure all documentation is complete 1.
- Conducting face-to-face handoffs whenever possible to allow for real-time questions and clarifications, reducing the risk of miscommunication 1.
- Implementing an electronic transfer system that integrates with the hospital's electronic health record to improve information accuracy and accessibility.
- Regular interdepartmental training sessions focusing on transfer procedures help staff understand expectations and responsibilities.
- Establishing clear criteria for patient transfers based on acuity levels and care needs ensures appropriate unit placement.
- Creating a culture of continuous improvement through regular evaluation of transfer processes and addressing identified issues promptly helps maintain high-quality care transitions. These strategies collectively reduce transfer-related errors, improve continuity of care, and enhance patient safety during transitions between units, as supported by recent studies 1. Key recommendations for safe transfer include having designated consultants with overall responsibility for the organization and infrastructure of transfers, drawing up local guidelines, and ensuring the transfer of responsibility for the patient's care is agreed upon by both parties 1. Additionally, patients with severe brain injuries should undergo tracheal intubation and mechanical lung ventilation before transfer, and should be accompanied by a clinician with appropriate training and experience in the transfer of patients with acute brain injury 1. Overall, a comprehensive approach to patient transfer that prioritizes clear communication, careful planning, and continuous improvement is crucial for ensuring patient safety and high-quality care transitions.
From the Research
Strategies to Improve Transferring Patients to Other Units
- Implementing a standardized handoff process between units can reduce patient harm and improve communication between providers 2
- Using a multidisciplinary team to develop a standardized handoff process and tool (checklist) can increase adherence to the process and care team satisfaction 2
- Improving transfer notes (TNs) can optimize patient safety, especially when patients are downgraded from high acuity settings such as intensive care units (ICU) 3
- Implementing a quality improvement initiative can increase the completion rate and quality of TNs, facilitating better and safer care of patients moving from one unit to another 3
- Collaborating between departments, such as the emergency department, trauma service, and surgical intensive care unit (SICU), can improve patient flow and reduce time spent in the emergency department 4
- Developing a protocol to expedite transfers from the emergency department to the SICU can result in significant time savings and improved care for injured and critically ill patients 4
Remote Patient Monitoring
- Remote patient monitoring (RPM) can be beneficial in improving postoperative outcomes for cardiac surgery patients by allowing for daily monitoring of vital parameters and early detection of complications 5
- RPM can also be effective in managing chronic medical conditions, such as heart failure, by empowering both medical providers and patients to monitor disease progression and symptomatology 6
- RPM can potentially reduce hospitalizations and readmission rates by allowing for early interventions and promoting patient disease management 6