Improving physician's hand over among oncology staff using standardized communication tool

Abstract

Cancer patients are frequently admitted to hospital for many reasons. During their hospitalization they are handled by different physicians and other care providers. Maintaining good communication among physicians is essential to assure patient safety and the delivery of quality patient care. Several incidents of miscommunication issues have been reported due to lack of a standardized communication tool for patients' hand over among physicians at our oncology department. Hence, this improvement project aims at assessing the impact of using a standardized communication tool on improving patients' hand over and quality of patient care. A quality improvement team has been formed to address the issue of cancer patients' hand over. We adopted specific hand over tool to be used by physicians. This tool was developed based on well-known and validated communication tool called ISBAR - Identify, Situation, Background, Assessment and Recommendation, which contains pertinent information about the patient's condition. The form should be shared at a specific point in time during the handover process. We monitored the compliance of physician's with this tool over 16 weeks embedded by four ‘purposive’ and ‘sequential’ Plan-Do-Study-Act (PDSA) cycles; where each PDSA cycle was developed based on the challenges faced and lessons learned in each step and the result of the previous PDSA cycle. Physicians compliance rate of using the tool had improved significantly from 45% (baseline) to 100% after the fourth PDSA cycle. Other process measure was measuring acknowledgment of hand over receipt email at two checkpoints at 8:00 – 9:00 a.m. and 4:00 – 5:00 p.m. The project showed that using a standardized handover form as a daily communication method between physicians is a useful idea and feasible to improve cancer patients handover with positive impact on many aspects of healthcare process and outcomes.