Speakers
Description
Background
In December 2024, Kingston Health Sciences Centre (KHSC) transitioned from paper-based documentation to the Cerner Health Information System (HIS). Following implementation, variability emerged in the delivery of Transfer of Accountability and Information (TOA/I) during patient handovers. Communication failures during transitions of care are a recognized contributor to patient harm, highlighting the importance of standardized handover practices (Chapman et al., 2016). A structured approach to TOA/I supports the accurate and timely exchange of clinically relevant information, improving continuity of care and reducing the risk of errors (Chapman et al., 2016; Lavoie et al., 2021; RNAO, 2021).
Purpose
To develop and implement a standardized approach to TOA/I across clinical settings to improve communication and reduce the risk of patient harm.
Methods
Implementation was guided by the Knowledge-to-Action framework and informed by a review of the RNAO Transitions in Care and Services Best Practice Guideline and relevant literature. Findings informed the development of corporate and nursing-specific policies that established expectations for TOA/I.
Education was delivered through KHSC’s Nursing Practice Council and Nurse Educators using interactive learning activities, policy awareness initiatives, and point-of-care discussions. Policies were also presented at leadership forums to support engagement and implementation. Evaluation activities are ongoing and include audits assessing adoption, compliance, and practice outcomes.
Outcomes
Early evaluation identified variability in policy uptake across clinical areas. Key barriers included resistance to practice change and inconsistencies in HIS workflows and interfaces. Audit findings are being used to identify implementation gaps and inform sustainability strategies.
Lessons Learned & Implications for Practice
Targeted education and implementation support are required to improve adoption in areas experiencing challenges. In addition, variation in HIS handover workflows can create barriers to consistent practice. These issues have been escalated to a regional Cerner working group to support workflow standardization and the sustainable adoption of evidence-informed TOA/I practices.
Author(s) Credentials and Title
Tanis Proulx, MN – LPNP, BNSc, RN, Interprofessional Learning Specialist (Interim), Heather Mackulin, BHSc, BEd, BScN, MScN (Teaching Focus), RN, CCNE, Professional Practice Director and Operational Director of Allied Health (Interim), and KHSC’s Nursing Practice Council
What RNAO BPG or tool/toolkit is your abstract related to?
Transitions in Care and Services
| Organization Name | Kingston Health Sciences Centre |
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