Enhancing Patient Throughput from Emergency Department to Inpatient Unit with Electronic Handoff Implementation

Background: This evidence-based improvement project aimed to address communication issues during information exchange among healthcare professionals and the operational impacts of ineffective nurse-to-nurse reports among the emergency department (ED) to the inpatient units at a northern California hospital-based system hospital in San Leandro. The impacts of miscommunication and ineffective ways of giving nurse-to-nurse reports over the phone can result in delays in treatment and diagnosis, leading to ED overcrowding and decreased throughput. Problem: Communication issues during information exchange, specifically operational impacts of ineffective nurse-to-nurse report/handoff between the ED and inpatient units. Interventions: This project aimed to implement an electronic handoff report and a tool built into the electronic medical record to enhance communication, improve patient safety, and improve throughput in the ED. Outcome Measures: This project measured the percentage of patients transferred from ED to inpatient bed within 60 minutes and the patient safety incidents related to miscommunication or delays in transfer as the outcome measures. Results: 715 admissions occurred on medical surgical and telemetry units analyzed between June 17 and July 13, 2024. On average, 40% of patients departed ED ≤ 60 minutes. A total of 5 incidents occurred. Learnings resulted in employee coaching, counseling, process/workflow/education reviewed with staff. None were sentinel events. Conclusion: Implementing the electronic handoff tool significantly benefits patients and colleagues within the hospital, ensuring safe, timely, and effective transfers. Keywords: electronic handoff report, ED to bed, throughput