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Bedside reporting fully implemented at St. Michael’s

Toronto, May 10, 2013

By Patricia Favre

Nurses Ayelit Gabler and Grace Fryfogel exchange information about a patient at bedside.
Nurses Ayelit Gabler and Grace Fryfogel exchange information about a patient at bedside. (Photo: Yuri Markarov)

In a major milestone for patient-centered care at St. Michael’s Hospital, nurses on all medical and surgical units are now using bedside transfer of accountability to hand over patients during shift changes.

Traditionally, patient information was communicated between shifts through tape recordings or verbal briefings at nursing stations. Bedside handovers require nurses to exchange pertinent patient information such as clinical conditions and care plans at the patient’s bedside.

First implemented at St. Michael’s by the general surgery unit in February 2011, bedside handovers are closing potential gaps in care. “A poor hand-off can lead to misunderstandings and lost information. That can have real consequences, such as medication misuse,” said Ayelit Gabler, a nurse in the cardiology unit. “Bedside reporting helps ensure a clear understanding of the patient’s status, care plan, anticipated changes and any safety concerns.”

This new practice also gives patients the opportunity to ask questions, clarify information and engage more easily in their own care which may, in turn, relieve anxiety.

“It makes me feel more human,” said Clara Burt, a former patient at St. Michael’s. “It’s easy in a hospital to feel like you’re just there, you’re just the patient. But when your nurses are actually standing there talking with you – that’s a good thing.”

Bedside transfer of accountability was part of St. Michael’s quest to achieve designation as a Registered Nurses Association of Ontario Best Practice Spotlight Organization. It was spread to additional inpatient units to maintain the BPSO designation and enhance quality patient care.

In addition to bedside handovers, St. Michael’s continues to seek new ways to improve transfer of accountability processes. Next steps include spreading the implementation of bedside safety checks by two registered nurses during handovers in the Intensive Care Unit and improved communication for transfers between inpatient units and patient care areas such as diagnostic imaging.