2017 HSC Section 2 - Practice Management

Successful Handoffs and Patient Safety

Table 2 Weighted least squares multiple regression of successful handoffs on different organizational factors

Partial R 2

Organizational Factor

95% CI

"

Supervisor support

G .01

.02 .15

( j 0.07, 0.11) (0.07, 0.23) ( j 0.27, j 0.10) ( j 0.08, 0.06) (0.18, 0.28) ( j 0.11, 0.03) (0.77, 0.89)

Organizational learning Teamwork within units Communication openness

.01 .02

*** ***

j .19 j .01

G .01

Staffing

.07

.23

***

Management support Teamwork across units

G .01

j .04

.44

.83

***

Included all hospital staff responses; weight was a hospital’s response rate; N = 1,052. Controls included teaching hospital, government hospital, bed size, and region. R 2 was .83 for full model; R 2 was .31 for control variables only. * p G .05. ** p G .01. *** p G .001.

clinical staff responses, thereby adding credence to their im- portance. Staffing had a positive association with perceived successful handoffs in the analysis of manager responses ( " = .21, 95% CI [0.15, 0.28], p G .001) and of clinical staff responses ( " = .18, 95%CI [0.13, 0.22], p G .001). Similarly, perceived management support for safety had a positive as- sociation with perceived successful handoffs in the analysis of manager responses ( " = .10, 95% CI [0.01, 0.18], p G .05) as

[0.63, 0.75], p G .001). Meanwhile, the association between perceived teamwork within units and perceived successful handoffs was similarly negative in the clinical ( " = j .11, 95% CI [ j 0.18, j 0.04], p G .01) and management staff ( " = j .15, 95% CI [ j 0.27, j 0.04], p G .01) models. The staffing and management support for safety vari- ables had a significant positive association with perceived successful handoffs in analyses of both management and

Table 3 Organizational factors that may influence successful handoffs: Comparing management and clinical staff perceptions

Management a mean Clinical b mean Difference Significance ( t Test)

Organizational factor

Supervisor support for safety Organizational learning Teamwork within units Communication openness

86.3 84.3 89.4 77.5 66.0

73.2 72.1 79.9 60.0 57.3 67.6 57.0

13.1 12.2

*** *** *** *** *** *** ***

9.5

17.5

Staffing levels

8.7

Management support for safety 85.8

18.2 11.0

Teamwork across units

68.0

Values reflect the average percentage of people at each hospital that agreed or strongly agreed with the questions that related to the variable of interest; N = 1,047 hospitals. Question responses were based on a 5-point Likert scale. a Management consists of hospital staff that selected their primary staff position as administration/management. b Clinical staff consists of physicians, physician assistants, nurse practitioners, registered nurses, licensed practical nurses, and medical assistants. * p G .05. ** p G .01. *** p G .001.

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