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Article
Publication date: 1 February 2013

Janis L. Gogan, Ryan J. Baxter, Scott R. Boss and Alina M. Chircu

Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting…

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Abstract

Purpose

Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting control theory, the aim of this paper is to discuss how these latter two disciplines can be combined to further improve patient safety in handoffs.

Design/methodology/approach

A literature review on studies of patient safety, clinical processes and clinical handoffs was conducted in leading medical, quality, and information systems journals.

Findings

This paper issues a call for research using a trans‐disciplinary methodology to shed new light on information quality issues in clinical handoff processes, which in turn should improve patient safety.

Research limitations/implications

The literature review employed systematic, heuristic, iterative and practical criteria for identifying and selecting papers, trading off completeness for multi‐disciplinarity. No prior empirical patient safety studies combined process management and accounting control theory.

Practical implications

The above‐noted trans‐disciplinary analytic approach may help medical professionals develop more effective handoff processes, checklists, standard operating procedures (SOPs), clinical pathways, and supporting software, and audit and continuously monitor their implementation.

Originality/value

This paper responds to recent calls for trans‐disciplinary research on healthcare quality improvement. The literature review is valuable for understanding clinical handoff problems and solutions from multiple perspectives. The proposed combination of two theories – accounting control theory and business process management – is novel and useful for describing, improving and monitoring handoff processes in the broader context of clinical processes, using a common terminology for information quality traits.

Article
Publication date: 12 April 2013

Alina M. Chircu, Janis L. Gogan, Scott R. Boss and Ryan Baxter

The purpose of this paper is to examine how clinical handoffs affect clinical information quality (IQ) and medication administration quality.

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Abstract

Purpose

The purpose of this paper is to examine how clinical handoffs affect clinical information quality (IQ) and medication administration quality.

Design/methodology/approach

A case study was conducted in a US hospital. The authors applied a business process management (BPM) perspective to analyze an end‐to‐end medication administration process and related handoffs, and accounting control theory (ACT) to examine the impact of handoffs on IQ and medication errors.

Findings

The study reveals how handoffs can lead to medication errors (by passing information that is not complete, accurate, timely or valid) and can help reduce errors (by preventing, detecting and correcting information quality flaws or prior clinical mistakes).

Research limitations/implications

The paper reports on one case study on one hospital unit. Future studies can investigate the impact of clinical IQ on patient safety across the multitude of health information technologies (e.g. computerized provider order entry (CPOE), electronic medication administration records (EMAR), and barcode medication administration systems (BCMA)) and approaches to process design and support (e.g. use of clinical pathways and checklists).

Practical implications

The findings can contribute to more successful design, implementation and evaluation of medication administration and other clinical processes, ultimately improving patient safety.

Originality/value

The paper's main contribution is the use of accounting control theory to systematically focus on IQ to evaluate and improve end‐to‐end medical administration processes.

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