St. Elizabeth Healthcare Introduces “No-Excuse Reporting “

St. Elizabeth Healthcare-Edgewood in Cincinnati, OH, is a non-profit suburban hospital seeing about 77,000 emergency department (ED) patients per year. The ED recognized a significant barrier to quality and efficiency in the care of admitted patients was driven by suboptimal communication and accountability for patient handover and transfer issues. When the ED called to report on a patient, the floor nurse wasn’t available. When the floor nurse called back, the ED nurse wasn’t available. This form of “telephone tag” occurred daily and was frustrating to all staff. Key stakeholders from the ED and inpatient units decided to implement a strategy addressing handover communication called “No-Excuse Reporting. “ No-excuse reporting established an environment in which a report is given to a nurse, even if the primary nurse is not available. The patient will then be received by someone on the floor when the patient is ready to move, even if the primary provider is unavailable. The key to success is that care is not delayed by holding patients in the ED, and the inpatient units now work more effectively as a team.