2019 HSC Section 2 - Practice Management

International Journal of Pediatric Otorhinolaryngology 114 (2018) 120–123

N. Murray et al.

Declaration of interests

and otolaryngology residents. This suggests that the tool can be e ff ec- tively utilized in inter-disciplinary hando ff s to facilitate information transfer to potential fi rst responders. The scope of our current study was not broad enough to address some pertinent related questions, such as: 1) How well and how long do subjects retain the knowledge they gained regarding utilization of the CARE hando ff tool, 2) How well can the tool be utilized by an even wider group of fi rst responders including nurses or advanced practi- tioners, and, the most important question, 3) Can we demonstrate a real impact of the hando ff tool on patient safety. These are all areas of ongoing study for our group. When considering the complexities of patients with a tracheotomy, a large amount of information must be conveyed during each hando ff . It is logical that streamlining the crucial airway information into a simple tool may improve the consistency in which this information is turned over. This logic is shared by the Joint Commission, as evidenced by their push over the last 10 years to improve hando ff s, and this logic is speci fi cally applied in their 2012 “ SHARE ” system for hando ff solu- tions. This study and the development of our CARE airway hando ff tool involves all aspects of SHARE, but speci fi cally exempli fi es three of the fi ve components: S tandardize critical content, H ardwire tools into the hospital system, and E ducate successful handover technique. The CARE classi fi cation system is an innovative method to quickly transfer critical airway information to any involved caregiver. The correct intubation technique in a tracheostomy-related airway emer- gency can save a life; we believe that a fast, reliable, easy-to-learn hando ff tool, like the CARE system, can improve patient safety for this vulnerable population. We have demonstrated that this system can be learned and applied by pediatric residents and otolaryngologists with no statistically signi fi cant di ff erence, and with substantial interrater reliability. Future research is needed in the application of this classi fi - cation system to hospitalized patients in real time hando ff s. The system may also prove to have utility for medical decision-making, with regard to risk strati fi cation, in areas of medical care other than hando ff s. 5. Conclusions

None.

Funding

None.

Acknowledgements

None.

References

[1] The Joint Commission, Improving hando ff communications: meeting national patient safety goal 2E, Joint Comm. Perspect. Patient Saf. 6 (2006) 9 – 10 15 . [2] Joint Commission Center for Transforming Healthcare releases targeted solutions tool for hand-o ff communications. Joint Commission Perspectives ® , 32 (8):1 – 3, Joint Commission on Accreditation of Healthcare Organizations, 2012 PMID: 22928243 . [3] Kaveh G. Shojania, Bradford W. Duncan, Kathryn M. McDonald, Robert M. Wachter, J.D. Amy J Markowitz (Eds.), Making Health Care Safer: A Critical Analysis of Patient Safety Practices Evidence Reports/Technology Assessments, No. 43, Agency for Healthcare Research and Quality (US), Rockville (MD), 2001 JulReport No.: 01 – E058 . [4] Making Health Care Safer II, An Updated Critical Analysis of the Evidence for Patient Safety Practices Evidence Reports/Technology Assessments, Agency for Healthcare Research and Quality (US), No. 211 Rockville (MD), 2013 Mar Report No.: 13- E001-EF . [5] P.H. Pucher, M.J. Johnston, R. Aggarwal, S. Arora, A. Darzi, E ff ectiveness of inter- ventions to improve patient handover in surgery: a systematic review, Surgery (St Louis) 158 (2015) 85 – 95 . [6] S. Halvorson, B. Wheeler, M. Willis, J. Watters, J. Eastman, R. O'Donnell, M. Merkel, A multidisciplinary initiative to standardize intensive care to acute care transitions, Int. J. Qual. Health Care 28 (2016) 615 – 625 https://doi.org/10.1093/intqhc/ mzw076 . [7] M.T. Bigham, T.R. Logsdon, P.E. Manicone, C.P. Landrigan, L.W. Hayes, K.H. Randall, P. Grover, S.B. Collins, DE Ramirez, C.D. O'Guin, C.I. Williams, R.J. Warnick, P.J. Sharek, Decreasing hando ff -related care failures in Children's hospitals, Pediatrics 134 (2014) e572 – e579, https://doi.org/10.1542/peds.2013- 1844 . [8] A.L. Hughes, N. Murray, T.A. Valdez, R. Kelly, K. Kavanagh, Development of the Connecticut airway risk evaluation (CARE) system to improve hando ff communica- tion in pediatric patients with tracheotomy, JAMA Otolaryngol Head Neck Surg 140 (2014) 29 – 33, https://doi.org/10.1001/jamaoto.2013.5550 .

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