P0415 - There’s an app for that! Using a smartphone-based application for accurate and efficient patient handoff.

Background: Accurate and efficient handoff is a critical part of hospital-based patient care. In the current era of smartphones and rapidly advancing technology, multi-platform based applications are an integral part of professional life. This quality improvement project introduced a free, HIPAA compliant, multi-platform handoff application (Listrunner app, Listrunner, Inc. San Francisco, CA) to improve the accuracy and efficiency of patient sign-out in a single academic center within the pediatric cardiology fellowship program.

Methods: Listrunner app was implemented to improve handoff accuracy, efficiency, and fellow satisfaction. Prior to execution, an anonymous survey was performed to assess the previous handoff process. This survey consisted of questions on a 5 point scale (1-very unsatisfied to 5-very satisfied) covering demographics, level of satisfaction, efficiency of updating the patient list, ability to make on-the-go updates, and accuracy of information at the time of sign-out. On-time handoffs were defined as an up to date patient list by 5 pm. Accuracy was defined by medications, patient location, lab results, and treatment plan on the patient list matching the electronic medical records (EMR) per fellow reporting. Following education and training on the website (www.listrunnerapp.com) and smartphone application, each fellow was again surveyed to assess the Listrunner application at 1 and 6 months after implementation.

Results: Prior to Listrunner, there was 20% satisfaction with the prior handoff, with only 40% occurring on-time, largely secondary to the inability to make on-the-go updates. After implementation of Listrunner, 100% of fellows surveyed were either satisfied or very satisfied at both 1 and 6 months post-intervention. Fellows were able to make on-the-go updates resulting in 100% on-time updated handoffs. Compared to prior handoff practices, 80% of fellows were satisfied with the accuracy at time of handoff and 40% felt their time spent updating the handoff after clinical duties was decreased by at least 30 minutes.

Conclusions: Implementation of the Listrunner handoff application improved satisfaction, on-time patient handoff, and document accuracy at the time of pediatric cardiology fellow sign-out. The ability to make on-the-go updates on patient status, orders, results, and treatment plan improves not only communication, but also provides smoother work-flow for trainees while decreasing time spent on documentation after clinical duties. Future interventions will aim at integrating the new application into the EMR for automatic location, medication, and result updates, in order to further improve accuracy of the handoff document and prevent associated medical errors.