Patient Handoffs. How To Get It Right?

So, I recently read this article regarding handoffs in radiology. Here is a link if you are interested, CLICK ME. This is something we actually do all day, every day and obviously involves passing a patient from one department to another. You would think that this is a simple process and mistakes never happen, but then, you would be wrong. The process of, for example bringing a patient down to the radiology department for a CT scan, has some built in obstacles to overcome. And this article identified areas for improvement. So let's discuss this topic.

Patient care transitions can pose particular challenges, especially around communication. In radiology, frequent transitions of care occur all the time. This “handoff” process has been identified as a leading cause of medical error, and handoffs can pose a major communication challenge for some practices.

A lot of research has been conducted on patient care transitions for medicine, surgery and in some institutions, radiology. Some communication errors in imaging involve choices of protocols, scanning the right/wrong patient and scanning the right/wrong body part. This can not only endanger patients, but also make radiologists and technologists vulnerable to litigation. In fact communication failures in these moments are among the top five causes of litigation in radiology and these communication failures can result in significant patient morbidity and mortality.

So what can be done to facilitate good transitions?

* Focus on individual behaviors. Train staff on potential sources of error (i.e., checking order requests and matching 2 or 3 unique identifiers, active listening). Use tools like notetaking, repeating information back, checklists and “stop the line” when something doesn’t add up.

* Focus on team behaviors. Designate particular handoff protocols where for example, the transporter is checking the patient identifiers and then the CT or Rad Tech checks it again before they image. This type of double check system is expected in a “safe practice” environment. Some institutions use a slip system, where a nurse or transporter has to sign the patient in and out. I know of at least one center that calls this a "ticket-to-ride" and it sounds like a great idea.

* Try to reduce noise in team environments and limit interruptions. This is much easier said than done. The hospital environment can be crazy and very hectic at times. But it is part of our job to slow things down to a point where the department can operate efficiently and avoid mistakes at the same time. After all, you can only image one patient at a time.

And here is a nice quote from the authors of the article, ”An organizational culture that prioritizes patient safety, more closely aligns with provider goals, builds a stronger shared mental model of the role of handoffs in care transitions, and transforms handoffs from isolated communication events into true transfers of professional responsibility”.

Improving patient care transitions is crucial on so many levels, and requires cooperation between individuals and teams. Perfecting this process allows us to enhance patient safety, minimizing mistakes/errors and demonstrates that radiology practices can operate as high-reliability organizations, and advance patient care.

In fact, this process of perfecting transitions/handoffs allows one to follow Dr. Sajewicz’s golden rule, “Do the right test on the right patient for the right reason”. If you want to learn more about becoming an expert communicator as a CT technologist and operating at a higher level than your peers, take a look at what my course on patient communication has to offer. Go to www.SpeakToPatients.com. Yes, this course costs money. Sorry about that, but you get to learn a ton about communicating with patients and your radiology staff and you get several bonuses as well as 1.5 Category A continuing education credits at the same time. This course has been approved by the ASRT and of course comes with a certificate of completion once you pass the quiz at the end.

With this course, I can teach any technologist:
* How to put the patient at ease instantly,
* How to stand out in a team setting and get noticed by the department manager and radiology staff,
* How to get happier and more cooperative patients,
* How to pick up on mistakes by others and prevent your own,
* How to accelerate your communication skills and career,
* And all the while, you are delivering exceptional patient care at the same time!


However, if you aren’t in the market for a paid course or CE credits, I do happen to have a FREE course you can try which is aimed at helping you become one of the most desirable technologists to work with at your institution. For this completely 100% FREE course, just go to www.CTSuperTech.com.