Patient Handoff Practices in the NAEC Accredited Epilepsy Centers
Abstract number :
2.341
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2203919
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Olga Selioutski, DO – University of Mississippi Medical Center; Susan Herman, MD – director of the Epilepsy Program, Professor, Department of Neurology, Barrow Neurological Institute; Matthew Garlinghouse, PhD – Department of Neurological Sciences – University of Nebraska Medical Center; Olga Taraschenko, MD, PhD – Department of Neurological Sciences – University of Nebraska Medical Center
Rationale: As defined by the Joint Commission, patient handoff is a transfer and acceptance of patient care responsibility achieved through effective communication. It is a real-time process of passing patient-specific information from one or several caregivers to another team of caregivers aimed to ensure uninterrupted and safe patient care. While in Epilepsy Monitoring Unit (EMU), patients are cared for by the healthcare teams at different levels of involvement: nursing staff; physicians, physicians in training, Advanced Practice Providers; EEG technologists and EEG assistants. These care teams might be assigned to the asynchronous shifts, which minimize opportunities for interactions between them at the times of handoffs. In general, the practice of patient handoff follows universal guidelines and principals with reflection on the unique features of the local practices. We conducted a survey of the Epilepsy Centers' directors to investigate the handoff process on patients admitted to the EMU or undergoing continuous EEG (cEEG) monitoring with particular focus on the interactions between the teams during the transition of care.
Methods: A list of directors of the epilepsy centers was obtained from National Association of the Epilepsy Centers (NAEC). The 79-question survey addressing specific details of handoff processes on patients admitted to EMU as well as patients undergoing cEEG monitoring was composed in REDCap and sent out to 265 Epilepsy Centers directors provided by NAEC. The questions included evaluation of the role of attendings, APPs, fellows, residents, RN/LPs and EEG technologists during patient handoff, frequency and methods used for handoffs, and handoff efficiency.
Results: Seventy out 265 (26.4%) NAEC-accredited center directors [10 (14%) Level 3 and 60 (86%) from Level 4 centers] responded to the survey. In vast majority of responses attending physicians were responsible for providing handoffs: 22 (100%) for weekly EMU handoff, 19 (91%) for weekly cEEG handoff, 8 (89%) for daily EMU handoff and 9 (100%) for daily cEEG handoff. The resident physicians were not involved at all in generating handoff reports, being exclusively on the receiving end of the communication chain. Similar observations are made about EEG technologists. Of particular concern was lack of any involvement of the nursing staff (RN, LPN) in EMU/cEEG handoffs. This is notably troubling as these members of the healthcare team are involved in daily and hourly patient care.
Conclusions: The handoff process on patients in EMU or on cEEG monitoring is driven by the attending providers. There is a need to design a handoff process model that includes all members of the patient care team, which is consistent with prior guidance from the AMA the Joint Commission.
Funding: None
Health Services (Delivery of Care, Access to Care, Health Care Models)