Advocate Lutheran General Hospital
Advocate Lutheran General Hospital in Park Ridge is the leading health care provider in Chicago’s North and Northwest suburbs, offering a Level I trauma center, access to national clinical trials and advanced medical technologies. Magnet-designated, it was named as one of the Top 100 hospitals in the nation by Truven Health Analytics. It provides patients with the most advanced treatment in cardiology, oncology, neurosciences, orthopedics and women’s health.
Many hospitals across the country face a similar challenge: ineffective handoffs of patient-specific information from one caregiver to another during shift changes. Team members at Advocate Lutheran General Hospital recognize that handoffs play a crucial role in ensuring the continuity and safety of the patient’s care, and wanted to improve their process.
“We had been getting patients from the emergency room who didn’t seemed to match with the data in the chart report even if it was accompanied by a verbal report,” said Brenda Deane, MSN, BS, RN, clinical manager of the Medical Coronary ICU/Interventional Unit. “And that could result in serious safety issues.”
Realizing procedures needed to change, Advocate Lutheran General Hospital pulled a committee together in 2014 to look for solutions. They quickly learned that many nurses were not meeting face to face for the handoff, or if they did, it likely was away from the patient.
“We had a group come together at the hospital level to try to re-imagine the handoff process,” said Monika Bogun-Dzioban, MSN, BS, RN, clinical manager of the Cardiac Telemetry Unit. “We soon realized that every Advocate site was experiencing similar issues.”
They discovered that performing the handoff at the bedside improved patient care and safety. Using industry best practices, committee decided to pilot the “swoop” technique when nurses in the Emergency Department hand off patients to the Surgical Intensive Care Unit. When transitioning care from one unit to the other, nurses have face-to-face discussions, with the patient present, where they can confirm care instructions and ask clarifying questions. It not only improves the patient experience and helps ensure safe transitions, but it also improves the relationships between caregivers.
“I think that the value of the ‘swoop’ is incredibly important to ensure the safety of our patients,” said Roseanne Niese, BSN, RN, director of Emergency Critical Care. “We took a problem that was happening around the hospital and made the process better for everyone. Our teams are testing the process and making adjustments appropriately. More recently, we implement the technique for transferring patients from the Intensive Care Unit to inpatient units. The patients are not critical anymore, but they still need that face-to-face assessment to ensure an effective and safe transition.”
Added Deane: “I think sometimes it’s that second set of eyes looking at that patient that is critical. When nurses perform that together, one might catch something that the other missed.”
Staff surveys have shown broad support for the procedure, and Bogun-Dzioban said hard evidence on reductions in safety events is being gathered now. With successful compliance and positive outcomes, this nurse-to-nurse communication technique is proving to be an invaluable tool for enhancing safety throughout inpatient units and will soon be deployed hospital-wide.