Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 May;31(5):311-7.
doi: 10.1038/jp.2010.202. Epub 2011 Jan 27.

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

J P Palma  1 , P J Sharek, C A Longhurst
Affiliations

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

J P Palma et al. J Perinatol. 2011 May.

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Electronic medical record (EMR)-integrated neonatal handoff tool. (a) Excerpt from the sign-out document and (b) sign-out data entry form.
Figure 2
Figure 2
Monthly usage of the electronic medical record (EMR)-integrated neonatal handoff tool since the intervention on 30 October 2008 (arrow) by (a) MDs, neonatal nurse practitioners (NNPs), (b) nursing (including charge nurses) and (c) ancillary staff (pharmacists, unit secretaries, case managers, nutritionists and audiologists).
See this image and copyright information in PMC

References

    1. Mukherjee S. A precarious exchange. N Engl J Med. 2004;351:1822–1824. - PubMed
    1. Frank G, Lawless ST, Steinberg TH. Improving physician communication through an automated, integrated sign-out system. J Healthc Inf Manag. 2005;19:68–74. - PubMed
    1. Institute of Medicine (US) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001. Committee on Quality of Health Care in America. - PubMed
    1. The Joint Commission 2006 Critical Access Hospital and Hospital National Patient Safety Goals. 2006 [cited]Available from: http://www.jointcommission.org/GeneralPublic/NPSG/06_npsg_dsc.htm.
    1. Petersen LA, Orav EJ, Teich JM, O’Neil AC, Brennan TA. Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events. Jt Comm J Qual Improv. 1998;24:77–87. - PubMed

MeSH terms