An Exploratory Study on how to Improve Bedside Change-of-Shift Process: Evidence from One Hospital Using Technology to Support Verbal Reporting

Abstract

Change-of-shift report, often referred to as patient handoff in the inpatient setting involves exchange of accurate and critical information between providers to ensure continuity of patient care. Inefficient communication significantly contributes to medical errors, affecting patient safety, and care quality. The current exploratory study was conducted to understand the issues associated with change-of-shift reporting that occurs throughout one hospital in its various nursing units. Nurses participating in the study were assigned a simulated patient case to develop a shift report to transfer to the incoming nurse. After completing the report, each nurse was interviewed using open-ended questions. Based on qualitative analysis of data obtained from sixteen one-on-one nurse interviews, ten themes were identified. The themes highlighted issues that posed coordination challenges for nurses, impeded nurse workflow, and underscored deficiencies in the bedside reporting process followed at the hospital. Recommendations are discussed on how to overcome these challenges.