Imagine that. Ingenious.
Using Ingenious Med’s
CrossCover Function to Save
Lives and Save Time
Glenn D. Focht. M.D.
Patient Safety and Operations Consultant, IM
imgldafo@gmail.com
Agenda
I. Why are effective patient handoffs so
important?
II. What barriers exist to safe handoffs in
your program or practice?
III. Can IM CrossCover be your time-saving
solution?
IV. Questions, next steps.
Why Are Effective Handoffs
so Important?
Webinar Live Vote Question:
– In the last 30 days, have you been aware of
an episode of patient harm that was the result
of a quality sign-out, a poor sign-out, or an
absent sign-out?
Why Are Effective Handoffs
so Important?
• Absence of effective handoffs:
– Causes avoidable death and disability in
US healthcare each day
• APACHE risk 600+% when no handoff occurs
– Drives extended length of stay and higher
readmission rates
Why Are Effective Handoffs
so Important?
• Absence of an evidence-based face to face
handoff is:
– a common reason for The Joint Commission,
federal and state regulatory citations
– a barrier to the clinical and financial
success of your practice or program
– a commonly cited cause of events
leading to malpractice
What Is an Effective Handoff?
• Key components of an effective handoff
process include:
– Patient name
– Room number and bed assignment
– MR # or acct #
– Meds
– Allergies
What Is an Effective Handoff?
Key Components continued
– Active problems
– Resuscitation status
– If-then statements of likely events
– Task list
IF
Temperature spikes above 39
THEN
Re-culture and add Vancomycin IV
What Is an Effective Handoff?
Key Components continued
Webinar Live Vote Question:
– In the past week, what percentage of the
handoffs you have participated in included all
the components of an effective handoff?
What Is an Effective Handoff?
Key Components continued
– Handoffs documented as most effective and
consistent by The Joint Commission and
safety literature when they occur face to face
in a distraction free environment
What Are the Barriers to
Safe Handoffs?
– Time constraints
– Culture of my program
– Absence of a good tool
– Distractions when trying to do
handoffs
What Are the Barriers to
Safe Handoffs?
Reply in the chat window.
Can IM CrossCover Be an Effective Tool
That Tackles Your Local Barriers?
YES
• Clinically effective
• Time saving
Can IM CrossCover Be an Effective Tool
That Tackles Your Local Barriers?
• Because billing and CrossCover data share
70% of content, a significant time and
efficiency savings occurs when shared
concurrently
– use of technology workflow reduced time
needed to construct a sign-out from 41.2
(range 8 -82) minutes to 27.1 (range 10-15)
* The Veteran Affairs Shift Change Physician to Physician
minutes*
Handoff Project, February 2010, vol 36. No 2
Can IM CrossCover be an Effective Tool That
Tackles Your Local Barriers? Continued
• Use of the ADT feed to auto-populate
multiple options saves even more
physician / provider time
• Time saved creates space for face to face
handoffs
Can IM CrossCover Be an Effective Tool That
Tackles Your Local Barriers? Continued
• Risk to hospitalized patients is dramatically
reduced when safe, evidence-based handoffs occur
• Risk management literature suggests
similar gains in safety when used for
complex, high-risk patients outside of the
hospital
Additional Uses and Potential Benefits:
Inpatient
• CrossCover is shared with charge nurses/
nursing supervisors
• CrossCover is shared with rapid response
teams
• CrossCover is shared with case
management
Additional Uses and Potential Benefits:
Across the Continuum
• CrossCover is shared with community
PCPs as a daily update ahead of discharge
– Captures many of the meaningful use clinical
continuity data points
How Do We Implement
Use of IM CrossCover Locally?
• Map out your current process for handoffs
– What works?
– What doesn’t?
– What steps are happening inconsistently or
not at all?
• Identify safety and inefficiency issues
inherent in your current process
How Do We Implement
Use of IM CrossCover Locally?
Next Steps
• Keep, modify or abandon
the implemented change?
• Another PDSA?
• If yes, what?
Analyze
• Identify issues of safety
• Define efficiencies /
inefficiencies
• What was unexpected?
• Summarize observations
Current Process for Handoffs
• What is working?
• What should change?
• How will I measure if
change resulted in
improvement?
• Find advocates
Change is implemented
• What happened?
• What was consistent?
• What did not happen?
• Collect feedback
How Do We Implement
Use of IM CrossCover Locally? continued
• Begin a trial of use among “the willing” /
early adopters
• Measure successes and share their stories
– Time saved
– Harm avoided
How Do We Implement
Use of IM CrossCover Locally? continued
• Study results and analyze gaps in use or
barriers
• Develop a plan for spread
– Align additional incentives within your program
– Tell patient care stories
– Engage colleagues who support this work from
risk, safety, quality “program management”
Using Ingenious Med’s CrossCover
Function to Save Lives and Save Time
Glenn D. Focht. M.D., Patient Safety and Operations Consultant, IM
imgldafo@gmail.com
Sarah Tipsin
Marketing Coordinator
sarah.tipsin@ingeniousmed.com
Appendix
Closing the Safety Gap in Patient Handoffs: Leveraging Technology to Build the Safety Net
by Glenn D. Focht, M.D., Patient Safety and Operations Consultant, IM
http://ingeniousmed.com/request-a-white-paper/
Bibliography / Additional References
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Understanding and Improving Patient Handoffs. Jt Comm J Qual Patient Saf 36 (Feb 2010).
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Additional References
continued
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Additional References
continued
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