A Team Approach to Inter-Unit Handovers of Care

Handovers of patients between hospital units, such as those that take place on admission of stroke patients from the emergency department to the neurosciences intensive care unit, are especially critical times, with significant potential for missed information, communication errors and interprofessional tensions. A quality improvement (QI) initiative aimed at standardizing team approaches to handovers was developed and implemented. To determine if this QI initiative affected clinician perceptions regarding interprofessional collaboration and handover quality in the emergency department and neurosciences intensive care unit of a rural academic medical center, a convenience sample of clinical nurses (RN) and licensed independent providers (LIP) caring for stroke patients were surveyed pre and post-implementation. Utilizing the Interprofessional Collaboration Scale and Handover Quality Rating Form to compare views surrounding handover of care and interprofessional collaboration between professions and units, this evaluation of a QI project demonstrated overall increased perceptions of teamwork (Mean difference 1.664, p = .029). LIP’s demonstrated a significant decrease in perceived isolation post-implementation (MD 3.700, p = .002), and RN’s reported increases in teamwork (MD 2.056, p = .020) and accommodation (MD 3.069, p = .035). Highly complex handover cases demonstrated significantly increased teamwork (MD 2.733, p = .019) and decreased perceptions of time pressure (MD -3.133, p = .002) post-implementation. These findings suggest that increased exposure to other professions through meaningful patient care interactions increases teamwork.