SHM Converge Scientific Abstract ePoster Gallery-After-Hours Communication in Acute Care: Establishing Best Practices for Cross-Cover Calls

Pdf Summary

This poster describes a cross-sectional survey of 105 hospital staff at M Health Fairview Woodwinds Hospital examining best practices for after-hours cross-cover communication in acute care. The goal was to identify where staff strongly agree on appropriate overnight communication, escalation, documentation, and deferral practices, and where policy clarification is needed.<br /><br />Responses showed strong consensus on several safety-critical behaviors. Staff overwhelmingly agreed that providers should evaluate patients bedside when deterioration is rapid, should be contacted for confusing or unsafe orders, and should be involved when physician judgment is needed. There was also near-universal agreement on maintaining a professional tone, documenting significant changes in condition or care plans, avoiding copied text in notes, and contacting the resident for patients on their service.<br /><br />However, several areas showed notable disagreement. Staff were divided on whether every cross-cover call requires a note, whether free-text messaging is preferred, whether multiple concerns in one message are confusing, and when it is appropriate to route concerns through hospitalists or a health unit coordinator. Many respondents also rejected deferring certain overnight requests—especially restraint renewals, medication/dose changes, and code status updates—to daytime teams.<br /><br />The study concludes that while there is strong consensus on core safety and professionalism standards, ambiguity remains in workflow specifics and escalation pathways. The authors recommend standardized after-hours protocols, targeted staff education, and refined institutional policies to improve patient safety, communication efficiency, and teamwork. Limitations include the single-institution design and reliance on self-reported perceptions. Future research should validate these findings across multiple hospital systems and link consensus practices to clinical and safety outcomes.

Asset Subtitle

Wally Jaranilla

Meta Tag

Author List Amber Ignaszewski, Wally Jaranilla

Category Research

Concept Cross-Cover Communication

Concept Escalation

Concept Bedside Evaluation

Concept Urgent Escalation

Concept Daytime Deferral

Distinguished Non-Finalist

Presenter Organization Fairview Health Services

Presenting Author Wally Jaranilla

Track Quality Improvement

Keywords

cross-sectional survey

after-hours communication

cross-cover

acute care

hospital staff

patient safety

escalation protocols

documentation practices

overnight communication

policy clarification

Cross-Cover Communication

Escalation

Bedside Evaluation

Urgent Escalation

Daytime Deferral