Making the transition to nursing bedside shift reports.
BACKGROUND
For hospitalized patients, shift handoffs between the offgoing and oncoming nurses, as represented in nurse shift reports, must include all critical information about a patient's plan of care, and that information must be well communicated. Few studies have provided the longitudinal results of the transition to bedside shift reports, and most of the data concern relatively short follow-up periods. A 20-bed inpatient nursing unit in a Midwestern academic health center made the transition to conducting nursing shift reports at the patient's bedside.


METHODS
Preparatory work for designing the bedside shift report process, which began in February 2009, included examining baseline patient satisfaction scores, reviewing the existing shift report processes, and identifying potential barriers and facilitators in moving to bedside shift reports. Unitwide implementation of the new bedside shift report process began in June 2009. In the redesigned process, off-going nurses were required to ask patients to write down any questions they would like to ask during the shift report.


RESULTS
For the first six months following implementation of bedside shift reports, there were significant increases in six nurse-specific patient satisfaction scores (scores increased at least 8.7 points, and percentile rankings increased from the 20th to > the 90th percentile when compared with similar nursing units in peer institutions). Longer-term results reflected subsequent declines and substantial month-to-month variation.


CONCLUSIONS
Although the transition to bedside shift reports met with some resistance, the transition was made smoother by extensive planning, training, and gradual implementation. On the basis of this pilot study, the decision was made to adopt bedside shift reports in all inpatient nursing units in each of the system's five hospitals.
Center for Health Care Quality, University of Missouri, Columbia, USA. wakefieldds@health.missouri.edu
Douglas S
DS
Wakefield
Roland
R
Ragan
Julie
J
Brandt
Megan
M
Tregnago
D000046:Academic Medical Centers / Q000458:organization & administration; D003142:Communication; D006801:Humans; D008137:Longitudinal Studies; D015146:Midwestern United States; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D061214:Patient Safety; D017060:Patient Satisfaction; D010561:Personnel Staffing and Scheduling; D010865:Pilot Projects; D011787:Quality of Health Care / Q000458:organization & administration*