Transitions of care between settings and clinicians are a time of vulnerability for patients, and can result in fragmented care, medication errors, avoidable readmissions, and patient/nurse dissatisfaction. Through the use of technology and a structured face-to-face handoff, the patient and family can be engaged in the transition across settings. The purpose of this project was to determine the feasibility and effectiveness of videoconference handoffs between inpatient, case management, and home care nurses, and the patients/families during transitions of care from hospital to home care. Videoconferences were conducted for 2 months with patients transitioning from two pediatric inpatient units to the hospital-based home care agency. The nurses and patient/family connected through a secure cloud-based videoconferencing platform. Participants discussed the patient's status, safety concerns, ongoing plan of care, what the patient/family could expect at home, and the coordination of equipment/supply needs and postdischarge visits. Videoconference handoffs (n = 10) were found to be feasible and address gaps in communication, coordination of care, and patient/family engagement during transitions from hospital to home care. Postpilot, nurses agreed the videoconference handoffs should continue with minimal modifications.
Suzanne W. Knight, DNP, RN, is an Educational Nurse Specialist, Professional Development & Education, University of Michigan Health System, Ann Arbor, Michigan.
Julie Trinkle, BSN, RN, is a Pediatric Homecare Nurse, Michigan Visiting Nurses, Ann Arbor, Michigan.
Dana Tschannen, PhD, RN, is a Faculty, School of Nursing, University of Michigan, Ann Arbor, Michigan.
The authors gratefully acknowledge the following individuals: DNP Committee Dana Tschannen, PhD (Chair); Deena Costa, PhD; Rhonda Schoville, PhD; Pilot Unit/area unit based committees and leadership teams; Staff Leads Jane Antosiak, Liz Baron, Diane Brown, Lori Barnett, Susan Draffen, Megan Duncan, Debbie Hardenbrook, Cheryl Leabu, Laura Mulligan, Shannan Shaw, Elizabeth Searl, Liz Stevens, Julie Trinkle, Beth VanTiem, and Linda Weinlander; Debra Kovacevich, Clinical Nursing Director at Home Care Services and preceptor; Preceptors Pat Schmidt, Manager Nursing Informatics, and Juanita Parry, Magnet Director; and Sharon Smith, Director of Nursing Professional Development & Education.
The authors declare no conflicts of interest.
Address for correspondence: Suzanne W. Knight, DNP, RN, Professional Development & Education, University of Michigan Health System, 300 N. Ingalls Bldg., Suite 6B15, Ann Arbor, MI 48109-5436 (firstname.lastname@example.org).