Impact of electronic medical record integration of a handoff tool on sign-out in a newborn intensive care unit

J Perinatol. 2011 May;31(5):311-7. doi: 10.1038/jp.2010.202. Epub 2011 Jan 27.

Abstract

Objective: To evaluate the impact of integrating a handoff tool into the electronic medical record (EMR) on sign-out accuracy, satisfaction and workflow in a neonatal intensive care unit (NICU).

Study design: Prospective surveys of neonatal care providers in an academic children's hospital 1 month before and 6 months following EMR integration of a standalone Microsoft Access neonatal handoff tool.

Result: Providers perceived sign-out information to be somewhat or very accurate at a rate of 78% with the standalone handoff tool and 91% with the EMR-integrated tool (P < 0.01). Before integration of neonatal sign-out into the EMR, 35% of providers were satisfied with the process of updating sign-out information and 71% were satisfied with the printed sign-out document; following EMR integration, 92% of providers were satisfied with the process of updating sign-out information (P < 0.01) and 98% were satisfied with the printed sign-out document (P<0.01). Neonatal care providers reported spending a median of 11 to 15 min/day updating the standalone sign-out and 16 to 20 min/day updating the EMR-integrated sign-out (P = 0.026). The median percentage of total sign-out preparation time dedicated to transcribing information from the EMR was 25 to 49% before and <25% after EMR integration of the handoff tool (P < 0.01).

Conclusion: Integration of a NICU-specific handoff tool into an EMR resulted in improvements in perceived sign-out accuracy, provider satisfaction and at least one aspect of workflow.

MeSH terms

  • Attitude of Health Personnel
  • Child Health Services* / organization & administration
  • Child Health Services* / standards
  • Continuity of Patient Care / organization & administration
  • Continuity of Patient Care / standards*
  • Electronic Health Records / standards*
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal / organization & administration
  • Intensive Care Units, Neonatal / standards*
  • Interdisciplinary Communication
  • Medical Informatics / methods*
  • Medical Staff, Hospital / education
  • Medical Staff, Hospital / standards
  • Prospective Studies
  • Quality Improvement
  • Staff Development
  • Workflow