Serious medical errors arise from poor communication among the medical professionals leading to additional medical burdens to patients, including more medical spending and patient dissatisfaction. Padgett (2018) states that close to 50% of the communication failures happen in the process of patient handoffs. Handoffs are widespread in contemporary healthcare networks and the everyday patient handoffs can reach as high as 4,000 (Padgett, 2018). Patients transfers implicate all disciplines in the medical profession, meaning that every clinician plays a role in some aspect of patient transition of care.
However, clinicians are not sufficiently trained in handoff communication skills. The shortcoming can be remedied by the use of structured and standardized handoff programs that seek to boost communication and patient safety. Two main tools have been established as evidence-based practices (EBPs) that clinicians can apply to mitigate against communication failure (Nisbet, 2017). These are the Targeted Solutions Tool (TST) and I-PASS, which comprises five quality components; illness severity (I), patient summary (P), action list (A), situational awareness and contingency plans (S), and synthesis by the receiver (S). This paper aims to discuss whether in hospitalized patients, is TST hands-off communication more effective than I-PASS handoff program in the safe transfer of hospitalized patients over 8 weeks.
TST offers a basis and framework for improvement in an organization that, if applied effectively, will enhance the efficacy of how clinicians communicate as a patient is transferred from one healthcare setting to another. It entails a web-based application system that organizations can leverage on to definitively gauge their actual performance and define impediments to success. In addition, TST enables an organization to authorize EBPs that are customized to address its specific needs (Padgett, 2018). I-PASS is a handoff program that seeks to reduce medical errors and preventable patient injury. The program is all-encompassing as it teaches physicians to communicate effectively and quickly digest pertinent patient information. It aims to enable the clinicians to formulate a shared cognitive criterion for every patient. In such a way, each one clinician implicated in handling the patient can make determinations in line with overall objective of enhanced care (Nisbet, 2017). I-PASS handoff program is based on a curriculum that uses healthy schemes to deal with people cultures that tend to resist change.
In general, medical practitioners are expected to abide by strict ethical conduct in handling patient information. The top consideration in the patient transfer program is informed consent, which guarantees patient autonomy. In research by Gault et al. (2017), informed consent seeks to ensure that the patient has realistic expectations about the doctor’s course of action and manage grievances and lawsuits. This is particularly important where several patient options necessitate the involvement of the patient. Allowing the patient their autonomy to choose an alternative guarantees their consent and involvement that is needed in case the desired outcome is not realized. Nonetheless, the patient has to be furnished with all pertinent information, including material benefits and risks. The patient should be capable to evaluate the information, weighing the options, and deciding free of coercion or undue pressure. The process must involve the ethical principles of integrity, confidentiality, and honesty.
In conclusion, communication failure in inpatient handling by different medical practitioners can be reduced with the use of handoff programs. TST and I-PASS are two leading EBPs that have been developed to deal with the problem. However, I-PASS is preferable in the safe transfer of hospitalized patients over 8 weeks as it is comprehensive. Even though it was principally developed to validate clinician handoffs, the I-PASS program can be applied to many other areas to improve patient care. In both programs, medical practitioners must provide patient care under the guidance of applicable ethical standards.
References
Gault, I., Shapcott, J., Luthi, A., & Infirmier, R. (2017). Communication in nursing and healthcare: a guide for compassionate practice. Sage.
Nisbet, E. (2017). A hands-on hands-off approach: governance of managed long-term care services in a context of rapid policy change.Public Management Review, 20(6), 824–844.
Padgett, T. M. (2018). Improving nurses’ communication during patient transfer: A pilot study. The Journal of Continuing Education in Nursing, 49(8), 378–384.