Standard Operating Protocols for Implementing Whiteboards

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Standard Operating Protocol for Whiteboard Communication. Published by the Research Centre for Clinical and Community Practice Innovation RCCCPI. Griffith University,Gold Coast campus Qld 4222,2008 Griffith University. Suggested Citation, Wallis M Chaboyer W McMurray A Wallen K Chang H Y 2008 Standard Operating. Protocol for Implementing Whiteboards to Assist with Multidisciplinary Communication on. Medical Units Griffith University Australia,About the Authors. Professor Marianne Wallis RN BSc Hons PhD FRCNA, Chair Clinical Nursing Research Griffith University and Gold Coast Health Service District. Queensland,Professor Wendy Chaboyer RN BSc Nu MN PhD.
Director Research Centre for Clinical and Community Practice Innovation Griffith University. Queensland,Professor Anne McMurray AM RN PhD FRCNA. Chair in Nursing Peel Health Campus and Murdoch University Western Australia. Ms Karen Wallen RN MN Hons PhD candidate, Lecturer School of Nursing and Midwifery Griffith University Queensland. Dr Hsiao yun Annie Chang RN BN MN PhD, Research Fellow Research Centre for Clinical and Community Practice Innovation. Griffith University Queensland,The primary contact person for this project is. Professor Wendy Chaboyer, Research Centre for Clinical and Community Practice Innovation.
Griffith University,Gold Coast campus QLD 4222,Tel 61 0 7 5552 8518. Email W Chaboyer griffith edu au,Acknowledgements, The development of these standard operating protocols has benefited from the assistance of. the following organisations, The Australian Commission on Safety and Quality in Health Care. Gold Coast Health Service District Queensland, Health care practitioners from Gold Coast Hospital. Standard Operating Protocol for Whiteboard Communication. Table of Contents Page,Whiteboard Communication 3, Overview of Whiteboard Communication in Medium Stay 5.
Medical Units, Detailed Description of Whiteboard Communication in Medium Stay 6. Medical Units,1 Preparation 7,2 Initial data entry 9. 3 Planning and referrals 10,4 On going update of progress 11. 5 Final review 12, Overview of Whiteboard Communication in Short Stay Medical Units 13. Detailed Description of Whiteboard Communication in Short Stay 14. Medical Units,1 Preparation 14,2 Initial data entry planning and scheduling 17.
3 On going update of progress 19,4 Final review 20. Variation in Whiteboard Communication 21,Summary 21. References 22,Appendix A Overview of the Research 23. Standard Operating Protocol for Whiteboard Communication. Whiteboard Communication, Clinical handover is defined as the transfer of responsibility and accountability. for patient care from one provider or team of providers to another Australian. Medical Association 2006 Clinical handover has been identified as a key. initiative to improve patient safety Australian Commission for Safety and. Quality in Health Care 2007 World Health Organization 2007 There are. many communication tools that can be used in the handover of patient care. one of which is the handwritten whiteboard When utilized as a tool for. communication the whiteboard facilitates collaborative work between health. care professionals in tracking and implementing quality patient care Xiao et al. 2007 The whiteboard provides a medium of support to multidisciplinary team. members in implementing and tracking safe and timely patient care. The Standard Operating Protocols SOPs set out in this document are based. on our research conducted in four wards of one hospital in 2007 2008. Chaboyer et al 2009 In this research we observed the use of the whiteboards. for over 45 hours and undertook in depth interviews with 11 staff members. These staff included physiotherapists dieticians and nurses who undertook. various roles such as clinical nurses educators and managers Our research. shows that when a change management process is used whiteboards can be. successfully implemented in a variety of clinical situations What appears to be. key however is involving the whole multidisciplinary team in the planning phase. where its function structure and usage are determined Also important is the. recognition that the whiteboard can make multidisciplinary communication more. efficient and effective In fact when successfully implemented whiteboards. were perceived to coordinate allied health referral and assist with timely patient. discharge preparation This in turn resulted in reduced length of stay and fewer. post discharge problems A short summary of this research is provided in. Appendix A, Standard Operating Protocol for Whiteboard Communication.
This document provides a set of SOPs for whiteboard communication and is. meant to act as a resource for its implementation These SOPS are presented. in two parts because whiteboard use varies depending on the type of unit and. the purpose of the whiteboard These two parts are, 1 Whiteboard communication in short stay medical units where patients. stay for less than a day e g screening clinics diagnostic clinics. emergency departments and, 2 Whiteboards communication in medium stay medical units where. patients stay for two or more days e g cardiac and oncology wards. The standard operating protocols will be presented in the following format. Standard operating protocols and,Possible variations to protocol. We have provided direct quotes from our research in sidebars to show what. staff members who use whiteboards to assist communication think about it We. use the stars icon to highlight tips and use a tick to indicate particular issues. that should be considered Finally boxes are used to display examples These. various symbols and their meanings are displayed below. Direct quote from the research,Tick Particular issue to be considered. Standard Operating Protocol for Whiteboard Communication. Overview of Whiteboard Communication Medium,Stay Medical Units.
Figure 1 provides a schematic overview of the whiteboard communication. process on medium stay medical units i e a few days or more Each of the. five steps is detailed in the following section,1 Preparation. Determine the purpose and structure of Concurrent Paper or. the whiteboard Electronic Documentation, Identify the location for the whiteboard Permanent documentation to. Design permanent documentation complement the whiteboard. associated with whiteboard information information is required. Train the multidisciplinary team,Expected Date of Discharge. 2 Initial Data Entry The EDD is crucial to effective. Patient details entered onto whiteboard discharge planning. Team to meet and estimate discharge Must be included at admission. date and revised regularly,3 Planning and Referrals. Doctors and nurses to meet at Whiteboard Coding System. whiteboard during ward round Decide on standardised coding. Discharge planning and allied health system,referral recorded on whiteboard.
4 On going Update of Progress Confidentiality, All of multidisciplinary team to update Sensitive information should not be. board as change occurs at least daily included on the whiteboard if it can. Concurrent documentation completed be seen by the public. 5 Final Review, Figure 1 Schematic Overview of Whiteboard Communication in Medium Stay Medical Units. It s a visual way of communicating with all the different allied health staff. that we would easily see when we came on the ward, Standard Operating Protocol for Whiteboard Communication. Detailed Description of Whiteboard,Communication in Medium Stay Medical Units. Preparing patients for discharge and ensuring all necessary supports are in. place before they go home is a key responsibility of the multi disciplinary team. Poor discharge preparation can lead to poor transition home and either delayed. discharge or readmission Parkes Shepperd 2001 Multidisciplinary. communication that maximises co ordination of the timely referral of patients to. members of the multi disciplinary team is key to safe and effective patient care. and good practice in discharge planning Dodek Raboud 2003 Plantinga et. In the research that underpins these standard operating protocols Appendix A. many medical teams had to communicate with one nursing team often divided. into groups caring for 10 15 patients per shift while the allied health. professionals had responsibility for patients on a number of different units This. research indicated that while some variation in whiteboard structure and. function is necessary it should be kept to a minimum to assist the medical and. allied health staff members who move from unit to unit. The standard operating protocol provides a detailed description of how to. undertake whiteboard communication and follows the schematic overview of. whiteboard communication Figure 1 The headings in the protocol follow the. five steps in this overview including,1 Preparation.
2 Initial data entry,3 Planning and referrals,4 On going update of progress and. 5 Final review, I just think it s better having a quick reference rather than them flicking. through the whole chart, Standard Operating Protocol for Whiteboard Communication. 1 Preparation, There are four aspects to the preparation for whiteboard communication. 1 Determining the purpose and structure of the whiteboard. 2 Location of the whiteboard, 3 Design of permanent documentation to run concurrently and.
4 Training of multidisciplinary team, 1 1 Determine the Purpose and Structure of the Whiteboard. Whiteboard communication has been used successfully where the. multidisciplinary team is focused on optimum patient discharge and. transition Each medical unit will have different allied health staff members. to whom patients are referred and may also have specific discharge. policies and procedures in place The use of the whiteboard needs to be. tailored to these local conditions Each ward will have to determine how. best to deal with patient bed moves The purpose and structure of the. whiteboard must be decided by the whole team if it is to be used. successfully, Possible purposes for whiteboard communication include. Coordination of diagnostic testing and health professional. Coordination of discharge planning,Ensuring patient readiness for discharge. Quick and easy visual communication of allied health. Visual cue for patients at high risk of adverse events e g. The idea was we initially wanted to get 2 to 3 days visibility to projected. discharge so we could make sure that the services were actually aligned to. patient care and they were going home with appropriate services. Standard Operating Protocol for Whiteboard Communication. Possible structures for whiteboard communication include. Rows each bed number, Columns patient name consultant doctor expected date. of discharge EDD common allied health referral, diagnostic test bookings discharge medications from.
pharmacy patient risk status and other comments, For whiteboards to accurately and consistently convey patient. information the professional groups contributing to it must take. responsibility for their own contribution therefore it is important. that they all have input into the development of the whiteboard. It s about trying to get discharges happening in a timely manner There is a. whole set of processes that also need to happen not just the doctor part of it. all but all the additional services that have to kick in ahead of time in order for. a patient to be discharged appropriately,1 2 Identify the Location for the Whiteboard. The whiteboard should be located in an area where there is easy access. for all staff preferably a high staff traffic area but a place where a number. of staff congregating will not impede traffic flow It must not be located in a. staff relaxation area Areas used by the public should be avoided if. possible The most important element is easy visibility to staff visiting the. Location of the whiteboard will also be linked to what information. is recorded If the board is in an area that can be accessed by the. public sensitive information should be omitted, 1 3 Design Permanent Documentation Associated with Whiteboard. Information, The team members need to be clear how the information on the. whiteboard relates to other documentation When admitted to acute care. hospitals patients may be transferred from ward to ward numerous times. It is imperative that the information about allied health referral is not lost. when the patient moves ward If staff determine that certain information. Standard Operating Protocol for Whiteboard Communication. must be available if patients are transferred a simple one page referral. form for each patient which tracks all allied health referral is. recommended,Concurrent Paper or Electronic Documentation.
Each ward will have to determine the extent to which paper or electronic. documents are used in conjunction with the whiteboard Key. considerations include, Information that must become a permanent part of the patient s. health record and, Information that is required to be transmitted when patients are. transferred from ward to ward, We use a referral form which is meant to go in the front of the chart so if the. patient did move the information would still be documented there yes you. might say that s a duplication but it s a slight safety check. on our research conducted in four wards of one hospital in 2007 2008 Chaboyer et al 2009 In this research we observed the use of the whiteboards for over 45 hours and undertook in depth interviews with 11 staff members These staff included physiotherapists dieticians and nurses who undertook

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