This document discusses improving patient-centered care through implementing bedside nursing handovers. It proposes using Kotter's 8-step change model and an Ishikawa diagram to structure the process. Implementing bedside handovers could increase patient safety and engagement, strengthen nurse-patient relationships, and ensure transfer of key clinical information between shifts. The document references literature supporting these aims and their alignment with Australian safety and quality health standards. Leadership styles that may facilitate successful implementation are also discussed.

1. INTRODUCTION
Quality health care “the degree to
which health services for
individuals and populations
increase the likelihood of desired
health outcomes and are
consistent with current
professional knowledge”
(Hughes, 2008).
Leadership
Improving patient-centred care
through bedside handover
Kotter’s 8-step change model
Ishikawa Diagram

2. Improving patient centred care through bedside handover
Increase patient engagement
Reduce preventable harm
Structured handover
Reduce ineffective
communication

3. Ishikawa
Diagram

4. Relevant Literature
Increase patient safety and quality of care
Nurse – Patient connection improvement
Enhancement of leadership and collaboration
Increased patient informant

5. NSQHS Standards
Implementation and monitoring
Improve reliability, safety and quality of healthcare
Partnering with consumer
Mutually valued outcomes

6. Communicating for safety standard
Transfer of responsibility and accountability
Structured clinical handover
Awareness of patient's goals and preferences
Patient, family and carer involvement

7. Kotters 8-step change model
1. Establish sense of urgency
2. Form a guiding coalition
3. Create a vision
4. Communicate vision

8. Kotters 8-step change model
5. Empower others to act on vision
6. Create quick wins
7. Build on change
8. Institutionalize Change

9. Leadership styles
Autocratic
Transformational
Democratic
Laissez-Faire
Leadership is the art of influencing others to achieve their maximum
potential to achieve.

10. Plans to further improve
Identify
Strengths
and
weaknesses
Find a mentor
Communication
Workshops

11. References
ACSQHC. (2022). Communicating for Safety Standard. Australian Commission on Safety and Quality in Health
Care. https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard
Australian Commission on Safety and Quality in Health Care. (2017). National Safety and Quality Health Service Standards. Safety and
Quality. https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf
Chien, L. J., Slade, D., Dahm, M. R., Brady, B., Roberts, E., Goncharov, L., Taylor, J., Eggins, S., & Thornton, A. (2022). Improving patient‐centred care through a
tailored intervention addressing nursing clinical handover communication in its organizational and cultural context. Journal of Advanced Nursing, 78(5), 1413–
1430. https://doi.org/10.1111/jan.15110
Cronin, N. (2020). Leadership Mentoring: Develop Your Leaders Through Mentorship | Guider Blog. Guider. https://www.guider-ai.com/blog/leadership-mentoring-
develop-your-leaders-through-mentorship
Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management, 49(6), 20–
25. https://doi.org/10.1097/01.numa.0000533770.12758.44
Haas, M., Munzer, B., Santen, S., Hopson, L., Haas, N., Overbeek, D., Peterson, W., Cranford, J., & Huang, R. (2019). #DidacticsRevolution: Applying Kotter’s 8-
Step Change Management Model to Residency Didactics. Western Journal of Emergency Medicine, 21(1), 65–70. https://doi.org/10.5811/westjem.2019.11.44510
Harel, Z., Silver, S. A., McQuillan, R. F., Weizman, A. V., Thomas, A., Chertow, G. M., Nesrallah, G., Chan, C. T., & Bell, C. M. (2016). How to Diagnose Solutions
to a Quality of Care Problem. Clinical Journal of the American Society of Nephrology, 11(5), 901–907. https://doi.org/10.2215/cjn.11481015

12. Hunter New England Health. (2009). Section 1: Introduction to ISBAR. Hunter New England New South Wales
Health. https://www.safetyandquality.gov.au/sites/default/files/migrated/ISBAR-toolkit.pdf
Joint Commission International. (2018). Communicating Clearly and Effectively to
Patients. https://store.jointcommissioninternational.org/assets/3/7/jci‐wp‐communicating‐clearly‐final_(1).pdf
Lewis, S. (2020, December 16). fishbone diagram (Ishikawa cause and effect). WhatIs.com. https://www.techtarget.com/whatis/definition/fishbone-diagram
Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2015). Perspectives of clinical handover processes: a multi-site survey across different health professionals. Journal of
Clinical Nursing, 25(1–2), 80–91. https://doi.org/10.1111/jocn.12986
Mardis, T., Mardis, M., Davis, J., Justice, E. M., Riley Holdinsky, S., Donnelly, J., Ragozine-Bush, H., & Riesenberg, L. A. (2016). Bedside Shift-to-Shift Handoffs. Journal of
Nursing Care Quality, 31(1), 54–60. https://doi.org/10.1097/ncq.0000000000000142
Sfantou, D., Laliotis, A., Patelarou, A., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in
Healthcare Settings: A Systematic Review. Healthcare, 5(4), 73. https://doi.org/10.3390/healthcare5040073
Silver, S. A., Harel, Z., McQuillan, R., Weizman, A. V., Thomas, A., Chertow, G. M., Nesrallah, G., Bell, C. M., & Chan, C. T. (2016). How to Begin a Quality Improvement
Project. Clinical Journal of the American Society of Nephrology, 11(5), 893–900. https://doi.org/10.2215/cjn.11491015
Small, A., Gist, D., Souza, D., Dalton, J., Magny-Normilus, C., & David, D. (2016). Using Kotter’s Change Model for Implementing Bedside Handoff. Journal of Nursing Care
Quality, 31(4), 304–309. https://doi.org/10.1097/ncq.0000000000000212
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a
Systematic Review. International Journal of Environmental Research and Public Health, 18(4), 1552. https://doi.org/10.3390/ijerph18041552