Department of Surgery, University of Dublin, Trinity College, Adelaide & Meath Hospital Incorporating National Children's Hospital, Tallaght, Dublin 24, Ireland.
Int J Surg. 2011;9(3):217-20. doi: 10.1016/j.ijsu.2010.11.012. Epub 2010 Dec 1.
Accurate handover of clinical information is imperative to ensure continuity of patient care, patient safety and reduction in clinical errors. Verbal and paper-based handovers are common practice in many institutions but the potential for clinical errors and inefficiency is significant. We have recently introduced an electronic templated signout to improve clarity of transfer of patient details post-surgical take. The aim of this study was to prospectively audit the introduction of this new electronic handover in our hospital with particular emphasis regarding efficacy and efficiency. The primary surrogate chosen to assess efficacy and efficiency was length of stay for those patients admitted through the emergency department. To do this we compared two separate, two-week periods before and after the introduction of this new electronic signout format. Users were not informed of the study. Information recorded on the signout included details of the emergency admissions, consults received on call and any issues with regard to inpatients. ASA grade, time to first intervention and admission diagnosis were also recorded. Our results show that introduction of this electronic signout significantly reduced median length of stay from five to four days (P=0.047). No significant difference in ASA grades, time to first intervention or overall admission diagnosis was obtained between the two time periods. In conclusion, this is the first study to show that the introduction of electronic signout post-call was associated with a significant reduction in patient length of stay and provided better continuity of care than the previously used paper-based handover.
准确的临床信息交接对于确保患者护理的连续性、患者安全和减少临床错误至关重要。口头和基于纸质的交接在许多机构中很常见，但存在临床错误和效率低下的巨大风险。我们最近引入了电子模板交班，以提高手术后患者详细信息转移的清晰度。本研究旨在前瞻性审核我们医院引入这种新的电子交接的情况，特别强调其效果和效率。选择的主要替代指标是通过急诊部门入院的患者的住院时间，以评估其效果和效率。为此，我们比较了引入这种新的电子交班格式前后两个独立的两周时间段。用户未被告知这项研究。交班记录的信息包括急诊入院的详细信息、呼叫时收到的咨询以及关于住院患者的任何问题。ASA 分级、首次干预的时间和入院诊断也被记录下来。我们的结果表明，引入这种电子交班显著缩短了中位住院时间，从五天缩短至四天（P=0.047）。在两个时间段之间，ASA 分级、首次干预时间或总体入院诊断没有显著差异。总之，这是第一项表明呼叫后引入电子交班与患者住院时间显著缩短相关，并提供比以前使用的纸质交接更好的护理连续性的研究。
