Transforming Care using Standardized Electronic Handovers
Care Process & Redesign
Technology
Yishun Health One Improvement Festival
National Healthcare Group
National University Health System
SingHealth
22 April 2025
To assess feasibility of transforming patient care using only electronic handovers documentation template via Next. Transforming Care using Standardized Electronic Handovers has improved quality and patient safety by streamlining continuity nursing.
Year Submitted: 2025
Published Date: 22 April 2025
Tags: Care Process ＆ Redesign, Technology, Workflow Redesign, Productivity, Cost Saving, Quality Improvement, Automation, Digitalisation
About this Content
Aims
To assess feasibility of transforming patient care using only electronic handovers documentation template via Next Generation Electronic Medical Record (NGEMR) -EPIC Hyperspace system for Acute and Emergency (A&E) Department admissions to general wards (GW) with the following targets to improve: Nursing efficiency and productivity, Nursing manpower utilization, Effective interdepartmental transfer of patient care.
Background
Nursing handover is defined as the transfer of professional responsibility and accountability of patients via exchange of crucial information between care teams to ensure consistency of patient care. The physical nursing handover process from A&E to GW consumes an average of 30 to 45 minutes, as A&E nurses are required to leave the department to handover to inpatient team. With the implementation of NGEMR integrated system using EPIC Hyperspace that synchronises patient’s records across restructured institutions in Singapore, the A&E team along with various stakeholders have reviewed to explore an alternative handover process to improve nursing efficiency in the midst of overcrowding situation in A&E.
Methods
The interventions include: Establish the Electronic Handover process, Establish the Exclusion criteria for EDIP Electronic Handover, Create a smartPHRASE template to pull patient’s existing information and data into a structured handover template, Perform Failure Mode and Effects Analysis (FMEA) at the initial phase to identify process functions/effects and potential failure modes.
Results
The total percentage of patients transfer via trolley and wheelchair were 73% and 27%, respectively. 3-20% of the transfer are performed by A&E nurses and 80-96% are by ancillary staffs. The average transfer with handover duration has shown a significant time saving up to 27 minutes. This implementation has helped to improve better utilization of manpower resources, work efficiency and productivity.
Conclusion
Transforming Care using Standardized Electronic Handovers has improved quality and patient safety by streamlining continuity nursing care handoffs using structured electronic smartPHRASE template to ensure critical information are documented. Operational resilience is achieved by switching to electronic handovers, improving efficiency, and allowing eligible patients to be transferred to GW by ancillary staff.
Lessons Learnt
The initiative is timely especially with overcrowding situations and high volume of lodgers in A&E. Nursing involvement in trolley transfers is remarkably low, indicating improved efficiency.
Additional Information
Exclusion criteria include DDIL cases, NEWS score >4, violent & agitated patient, high suicide risk, infusion pumps, ongoing blood transfusion, spinal nursing, hip/lower limbs fractures, patient with tubes e.g. chest tubes, tracheostomy, laryngectomy, ongoing CPAP/BiPAP therapy.
Keywords
Nursing, Efficiency, Productivity, Electronic Handovers, NGEMR, EPIC Hyperspace
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group, National University Health System, SingHealth |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Nursing, Healthcare Administration |
Applicable Specialty or Discipline | General Medicine, Healthcare Administrators |
Project Lead(s) | Chua.S.H., Chang.P.J. |
Project Member(s) | Ratnasari Yawieriin |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg
Project Attachment
794_KTPH_OIF 2025_Transforming Care using Standardized Electronic Handovers.pdf