Abstract
Electronic health records (EHR) have been adopted across the nation at tremendous effort and expense. The purpose of this study was to assess improvements in accuracy, efficiency, and patient safety for a high-volume pediatric surgical service with adoption of an EHR-generated handoff and rounding list. The quality and quantity of errors were compared pre- and post-EHR-based list implementation. A survey was used to determine time spent by team members using the two versions of the list. Perceived utility, safety, and quality of the list were reported. Serious safety events determined by the hospital were also compared for the two periods. The EHR-based list eliminated clerical errors while improving efficiency by automatically providing data such as vital signs. Survey respondents reported 43 min saved per week per team member, translating to 372 work hours of time saved annually for a single service. EHR-based list users reported higher satisfaction and perceived improvement in efficiency, accuracy, and safety. Serious safety events remained unchanged. In conclusion, creation of an EHR-based list to assist with daily handoffs, rounding, and patient management demonstrated improved accuracy, increased efficiency, and assisted in maintaining a high level of safety.
Similar content being viewed by others
References
Charles D, King J, Patel V, Furukawa M. Adoption Of Electronic Health Record Systems Among U.S. Non-Federal Acute Care Hospitals: 2008–2012. Onc Data Brief, No 9. Washington, Dc: Office Of The National Coordinator For Health Information Technology. March 2013.
Hillestad, R., Bigelow, J., Bower, A., et al., Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Aff (Millwood) 24(5):1103–1117, 2005.
Whalen Tv, Nasca Tj. Town Hall Meeting On Resident Duty Hours (Th03), American College Of Surgeons 95th Clinical Congress, Chicago Il. October 13, 2009.
Singh, H., Thomas, E. J., Petersen, L. A., and Studdert, D. M., Medical errors involving trainees: A study of closed malpractice claims from 5 insurers. Arch Intern Med 167(19):2030–2036, 2007.
Lofgren, R. P., Gottlieb, D., Williams, R., and Rich, E. C., Post-call transfer of resident responsibility: Its effect on patient care. J Gen Intern Med 5(6):501–505, 1990.
Clark, C. J., Sindell, S. L., and Koehler, R. P., Template for success: Using a resident-designed sign-out template in the handover of patient care. J Surg Educ 68(1):52–57, 2011.
Anderson, J., Shroff, D., Curtis, A., et al., The veterans affairs shift change physician-to-physician handoff project. Jt Comm J Qual Patient Saf 36(2):62–71, 2010.
Peterson, L. T., Ford, E. W., Eberhardt, J., Huerta, T. R., and Menachemi, N., Assessing differences between physicians’ realized and anticipated gains from electronic health record adoption. J Med Syst 35(2):151–161, 2011.
Ben-Assuli, O., Shabtai, I., Leshno, M., and Hill, S., Ehr in emergency rooms: Exploring the effect of key information components on main complaints. J Med Syst 38(4):36, 2014.
Petersen, L. A., Orav, E. J., Teich, J. M., O’neil, A. C., and Brennan, T. A., Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt Comm J Qual Improv 24(2):77–87, 1998.
Wohlauer, M. V., Rove, K. O., Pshak, T. J., et al., The computerized rounding report: Implementation of a model system to support transitions of care. J Surg Res 172(1):11–17, 2012.
van Eaton, E. G., Horvath, K. D., Lober, W. B., Rossini, A. J., and Pellegrini, C. A., A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg 200(4):538–545, 2005.
Starmer, A. J., Sectish, T. C., Simon, D. W., et al., Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. Jama 310(21):2262–2270, 2013.
van Eaton, E. G., Mcdonough, K., Lober, W. B., Johnson, E. A., Pellegrini, C. A., and Horvath, K. D., Safety of using a computerized rounding and sign-out system to reduce resident duty hours. Acad Med 85(7):1189–1195, 2010.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Systems-Level Quality Improvement
Rights and permissions
About this article
Cite this article
Raval, M.V., Rust, L., Thakkar, R.K. et al. Development and Implementation of an Electronic Health Record Generated Surgical Handoff and Rounding Tool. J Med Syst 39, 8 (2015). https://doi.org/10.1007/s10916-015-0202-x
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-015-0202-x