The Joint Commission recently released its new Targeted Solutions Tool™ (TST) for Hand-off Communications. This is an outstanding tool that every healthcare organization can utilize to improve patient care and coordination across all levels of the continuum of care. The Targeted Solution Tools are free to organizations accredited by The Joint Commission. Previous TST’s have addressed hand hygiene and wrong-site surgery and have proven very valuable. You’ll find this one even more valuable.
In our February 14, 2012 Patient Safety Tip of the Week “Handoffs – More Than Battle of the Mnemonics” and March 2012 What’s New in the Patient Safety World column “More on Perioperative Handoffs” we stressed that you need to implement tools that address the needs of each particular type of handoff that occurs in your organization. Though using a structured communication format or tool is important, the exact tool or format needed will vary by the nature of the handoff so “one size does not fit all”. The new Joint Commission TST for Hand-Off Communications takes on that very philosophy. It stresses that because there are so many root causes of failed handoffs you need to implement those proven solutions tailored to the root causes in play at your organization, not an off-the-shelf generic solution that addresses things you may already be doing well. Many of those root causes are listed in the summary document describing the program.
Their tools are tailored for a variety of handoffs. In their introductory webinar they highlighted handoffs between long-term care and acute care hospitals and handoffs from the emergency department to the inpatient units. But they have solutions in place for all the most common handoff scenarios. They have not yet posted tools for the shift-to-shift handoff but are in the process of piloting solutions for that as well and expect those tools to be up online within a few months. The tools and solutions were developed and implemented by the Joint Commission Center for Transforming Healthcare in conjunction with many participating hospitals you’ll readily recognize for their commitment to quality.
They stress the importance of the “sender” and the “receiver” getting together early in the implementation process to align their goals. They emphasize that the sender and receiver often have very different expectations about what they will get from a handoff. They have tools to help you determine what common root causes are present in suboptimal communications between your organization and your partners. Once you choose a type of handoff to focus on they provide tools that have been proven effective for that type of handoff and those types of root causes you’ve identified. Further, they provide measuring tools and audit tools so that you get feedback on your improvement endeavors. Since their programs heavily involved staff trained in LEAN and Six Sigma and RPI (Robust Process Improvement™), you will see statistical process control charts of defect rates, pareto charts of reasons for failed hanoffs, times series charts, etc. in their toolkits.
Are their solutions successful? In one handoff project involving an acute care hospital and long-term care facilities they were able to reduce 30-day readmission rates substantially and also helped lower hospital length of stay. In another they achieved a 33% reduction in the time to transfer patients from the ED to the acute care units
We have no doubt that any healthcare organization will find a tool to address handoff problems relevant to their own circumstances. This TST is a very valuable tool.
Read about many other handoff issues (in both healthcare and other industries) in some of our other columns:
May 15, 2007 “ ”
May 22, 2007 “ ”
August 28, 2007 “Lessons Learned from Transportation Accidents”
December 11, 2007 “Communication…Communication…Communication”
February 26, 2008 “Nightmares….The Hospital at Night”
September 30, 2008 “ ”
November 18, 2008 “ ”
December 2008 “Another Good Paper on Handoffs”.
June 30, 2009 “ ”
April 25, 2009 “ ”
April 13, 2010 “Update on Handoffs”
July 12, 2011 “Psst! Pass it on…How a kid’s game can mold good handoffs”
July 19, 2011 “Communication Across Professions”
November 2011 “Restricted Housestaff Work Hours and Patient Handoffs”
December 2011 “AORN Perioperative Handoff Toolkit”
February 14, 2012 “Handoffs – More Than Battle of the Mnemonics”
March 2012 “More on Perioperative Handoffs”
June 2012 “I-PASS Results and Resources Now Available”
August 2012 “New Joint Commission Tools for Improving Handoffs”
August 2012 “Review of Postoperative Handoffs”
The Joint Commission. Center for Transforming Healthcare. Joint Commission introduces new, customized tool to improve hand-off communications. June 27, 2012
Joint Commission Center for Transforming Healthcare. Improving Transitions of Care: Hand-off Communications.
A Look at the Joint Commission. Robust Process Improvement™ at the Joint Commission. Bulletin of the American College of Surgeons. August 2011 p. 75