New Shift-Change Handoff Enhances Patient Care

Shift Change Handoffs – A Family Member’s Story

“I noticed the patient’s information board with all of the contact information for each individual on the care team. Along with the partnership pledge located at various spots around the facility – your efforts of inclusion for family in the patient’s health care is not only visible but actively encouraged by your staff.

During shift change I witnessed the hand-off communication for the patient’s bedside report and WOW – [I was] Very Impressed!! I didn’t have to ask any questions of what was happening with my mother. All of the information I needed was right there and clear communication of incidents during the shift were noted. Once again, seeing this level of organization gave me confidence in your facility’s ability to take care of my mother.” – October 2019

Enhancing the transition that occurs with patients in between nursing shifts will improve the quality of care at all of our hospitals across the University of Maryland Medical System. Recent changes in this process are designed to ensure that patients know their plan of care, know who is in charge of their care and are involved in conversations about their care. 

The effort to refocus how nurses interact with patients at shift change began with the language we use to describe it. Previously called “bedside handoffs,” the more inclusive “shift-change handoffs” ensures that we are applying the same standards no matter where a patient is located – in a bed or elsewhere. The second step is to introduce the new nurse and explain to the patient, and to their families when appropriate, exactly what is happening in clear and succinct language. Finally, the nursing staff involves the patient in the conversation by inviting them to share information directly with the new nurse. Printed materials like wall clings and small signs on the patient’s bedside table reinforce these steps to the nursing staff, patients, and patient families.   

This consistency in communication across UMMS hospitals reduces the anxiety that our patients sometimes feel when facing a medical issue. Nursing staff say it also increases trust that patients have in the care they’re providing, making patients more likely to share concerns and symptoms and helping medical staff provide better care. UMMS will measure the success of the new process through stories like the one above, and through patient experience scores. 

How Does the New Shift-Change Handoff Work? 

  • Use the Right Language: Shift Change Handoff

  • Tell the Patient What’s Happening

  • Involve the Patient in the Conversation

“Good morning/evening Mr. Adams, Nurse Jones will be your nurse now and will take really great care of you today/tonight.”

“We are here to do shift-change handoff, which we always do at your bedside to make sure you receive the best and safest care.”

“It’s important to remember that Mr. Adams likes to have his glasses on his bed at all times. Mr. Adams, tell Nurse Jones how you’ve been feeling today.”

If patient is asleep and family member is present, the Personal Care note can be modified:

“Mr. Adams wants us to know that he has a hearing loss in his left ear.”