Improving Handoff Quality and Nursing Teamwork Between Intrahospital Settings with Transfer Checklists

Background. Frequent transitions between healthcare settings create opportunity for suboptimal handoffs, error, and compromised patient safety. These handoffs represent some of the more labor-intensive nursing activities and yet limited research has explored this significant exchange of information and responsibility.

Purpose. The purpose of the proposed project was to evaluate whether the implementation of a nursing transfer protocol would promote teamwork and collaboration between nurses in the Medical Intensive Care Unit (MICU) and medical oncology unit (MOU) and improve overall perception of handoff quality.

Design. This was a quasi-experimental project with pre-post comparison using the Nursing Teamwork Survey (NTS) and Manser rating tool for handoff quality (Manser Survey).

Methods. The Manser survey was distributed to nurses in both units to evaluate the quality of handoffs. Nurse volunteers from both units used data collected from the Manser surveys to create an oncology transfer checklist for use during transfers. Perceptions of teamwork between units were evaluated using the NTS both before and after creation of the transfer protocol. Quality of handoffs after implementation of the checklist was evaluated using the Manser survey.

Results. Neither the Modified NTS nor the Manser survey items demonstrated statistically significant improvement in scores.

Conclusions. While it is uncertain whether the oncology transfer checklist fundamentally changed handoffs, clinical results suggest that bringing two teams together to learn about their structural and role related processes and allowing them to collaborate on handoff improvement, supported improved handoffs and optimal patient care, and also helped to promote socialization, trust, situational awareness and teamwork that is essential between intra-hospital settings.