October 30, 2015

Why bedside shift reports are a quick win for quality, patient satisfaction

Daily Briefing

To improve quality and patient satisfaction, hospitals are rethinking the typical way nurses change shifts, Laura Landro reports for the Wall Street Journal.

Traditionally, nurse shift changes are often informal, with nurses meeting in the hallway or at the nursing station to provide "a rundown of their patients' status and needs," Landro writes.

Improving quality

But experts say so-called bedside shift reports—when nurses meet in the presence of the patient to share critical information during the handover—offer a more systematic, safer alternative. According to Landro, studies show bedside shift reports help reduce the number of patient falls and prevent safety issues like incompatible blood transfusion or air bubbles that form in arteries.

Involving patients in shift handoffs may reduce errors

Beverley Johnson, CEO at the Institute for Patient-and-Family-Centered Care, says that "conducting nurse change-of-shift report at the bedside with the patient and family should be viewed as a core safety strategy in hospitals today."

Bedside shift also reports also improve communication with patients and their families—which can boost patient satisfaction scores, Landro writes.

Implementation

Nurses at University of Washington Medical Center (UWMC) began using bedside shift reports in July after a patient and family advisory council recommended the change. One participant, Christine Hernandez, recalls how "hungry for information" she was when her husband spent six weeks in intensive care in 2007. "Shift change would have been a perfect opportunity for a family member to be present for a little rundown on his current status and expectations for the next shift," she says.

UWMC nurses spend between three and seven minutes with each patient during the shift change—and if patients or families have more questions, nurses can suggest connecting again after the report. In some cases, patients opt out of the process entirely. "If someone doesn't want us in there, that's totally fine too," says Patricia Kritek, a physician and associate medical director at UWMC.

Best practice
Joint bedside report

The University of Vermont Medical Center has used bedside shift reports since 2013. Nurses follow a six-step process to review new information and perform safety checks. One nurse, Kate Miller, says hearing a verbal report on patients in their presence helps "you see the person and not just a piece of paper."

And the patients like it too. "It left me with a secure feeling that the new nurse wasn't showing up without important information about me," says Thomas DeVarney, a recent patient at the medical center (Landro, Wall Street Journal, 8/26).

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