Comparing Provider Perspectives on Efficiency and Patient Safety With Paper and Digital Tools for Handoffs of Patient Care

Abstract

OBJECTIVES: Handoffs of patient care are opportunities for promoting efficiency and safety. With the shift from paper to digital records, we examine changes in provider perceptions of efficiency, errors, and confidence on a labor and delivery service at an urban, academic hospital. METHODS: An anonymous survey was sent during the use of a paper and digital handoff board. Descriptive statistics and χ2 analyses were used to compare provider perceptions. RESULTS: Survey responders were primarily resident (50.0%-54.8%) and attending (35.5%-50.0%) physicians, as well as one certified nurse-midwife. Responders' training levels did not differ significantly [χ2 (2)=2.61, P=0.27]. Time spent updating the board did not differ significantly [χ2 (4)=3.50, P=0.48], although there were fewer delays in initiating the handoff [χ2 (3)=27.03, P<0.001] when using a digital board. Providers reported fewer errors [χ2 (5)=18.26, P<0.01], and perception of patient safety was greater with the digital board [χ2 (4)=10.07, P <0.05]. Providers reported higher scores on the standardization of patient presentation [χ2 (4)=17.95, P=0.001] and greater ease of updating the records [χ2 (4)=20.75, P <0.001] with the digital board. CONCLUSIONS: Compared with provider perceptions of using a paper board, providers reported improved scores in efficiency, errors, safety, and standardization of patient presentation when using a digital board. Our findings document the benefit of transitioning to digital tools to facilitate handoffs, especially in a fast-paced labor and delivery setting.