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Patient handoff (also known as handover or sign-out) refers to the specific interaction, communication, and planning required to achieve seamless transitions of care from one clinician to another. Poor handoffs are associated with high rates of self-reported medical errors and adverse events.1-3 Effective and timely handoffs are essential to maintain high-quality medical care, reduce medical errors and redundancy, and prevent loss of information. Hospitalists are involved in the transfer of patient care on a daily basis and can lead institutional initiatives that promote optimal transfer of information between healthcare providers.
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KNOWLEDGE
Hospitalists should be able to:
Describe the key elements of a high-quality patient handoff (shift change or service change).
Explain the components and strategies that are critical for successful communication during handoffs.
List barriers to effective handoff and strategies to mitigate them to improve patient safety.
Describe the factors that influence handoff detail, components, and strategies.
Explain the strengths and limitations of various handoff communication strategies and procedures.
SKILLS
Hospitalists should be able to:
Communicate effectively and efficiently during patient handoff and use appropriate verbal and/or written modalities.
Demonstrate the use of read-back when communicating tasks.
Construct standardized patient summaries for oral and written delivery that permit customization by incorporating the unique characteristics of the patient and his/her diagnosis and treatment plan, healthcare provider, and timing of the handoff.
Evaluate all medications for accuracy regarding indication, dosing, and planned duration before handoff.
Use “if-then” statements for outstanding critical tasks, anticipated events, and any potential complications.
Synthesize clinical information efficiently and request clarification if necessary at the time of handoff receipt.
Update written and verbal handoffs with the most recent clinical information needed for effective transfer of care.
Limit interruptions during handoffs.
Identify the sickest patients and prioritize those for discussion during verbal handoff.
Communicate with patients and families to explain the handoff process and provide advance notification of the change in clinical care team members assuming care for the patient.
Engage stakeholders in institutional initiatives to streamline the incorporation of patient handoffs within clinical workflows and continuously assess the quality of handoffs.
Lead, coordinate, and/or participate in initiatives to develop and implement new protocols to improve and optimize handoffs.
Lead, coordinate, and/or participate in evaluation of new strategies or information systems designed to improve handoffs.
ATTITUDES
Hospitalists should be able to:
Recognize the importance and impact of handoff quality on patient safety.
Appreciate the value of real-time interactive dialogue between clinicians during handoffs.
Endorse handoffs as a priority at which time the focus is on transfer of patient care.
Develop and maintain a culture of continued clinician availability should questions arise after the patient handoff.
Adopt an attitude of professional responsibility for all patients who have been received during a handoff.
1. Horwitz LI, Meredith T, Schuur JD, Shah NR, Kulkarni RG, Jenq GY. Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med. 2009;53(6):701-710.
2. Kitch BT, Cooper JB, Zapol WM, Marder JE, Karson A, Hutter M, et al. Handoffs causing patient harm: a survey of medical and surgical house staff. Jt Comm J Qual Patient Saf. 2008;34(10):563-570.
3. Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121(11):866-872.
Patient handoff (also known as handover or sign-out) refers to the specific interaction, communication, and planning required to achieve seamless transitions of care from one clinician to another. Poor handoffs are associated with high rates of self-reported medical errors and adverse events.1-3 Effective and timely handoffs are essential to maintain high-quality medical care, reduce medical errors and redundancy, and prevent loss of information. Hospitalists are involved in the transfer of patient care on a daily basis and can lead institutional initiatives that promote optimal transfer of information between healthcare providers.
Want all 52 JHM Core Competency articles in an easy-to-read compendium? Order your copy now from Amazon.com.
KNOWLEDGE
Hospitalists should be able to:
Describe the key elements of a high-quality patient handoff (shift change or service change).
Explain the components and strategies that are critical for successful communication during handoffs.
List barriers to effective handoff and strategies to mitigate them to improve patient safety.
Describe the factors that influence handoff detail, components, and strategies.
Explain the strengths and limitations of various handoff communication strategies and procedures.
SKILLS
Hospitalists should be able to:
Communicate effectively and efficiently during patient handoff and use appropriate verbal and/or written modalities.
Demonstrate the use of read-back when communicating tasks.
Construct standardized patient summaries for oral and written delivery that permit customization by incorporating the unique characteristics of the patient and his/her diagnosis and treatment plan, healthcare provider, and timing of the handoff.
Evaluate all medications for accuracy regarding indication, dosing, and planned duration before handoff.
Use “if-then” statements for outstanding critical tasks, anticipated events, and any potential complications.
Synthesize clinical information efficiently and request clarification if necessary at the time of handoff receipt.
Update written and verbal handoffs with the most recent clinical information needed for effective transfer of care.
Limit interruptions during handoffs.
Identify the sickest patients and prioritize those for discussion during verbal handoff.
Communicate with patients and families to explain the handoff process and provide advance notification of the change in clinical care team members assuming care for the patient.
Engage stakeholders in institutional initiatives to streamline the incorporation of patient handoffs within clinical workflows and continuously assess the quality of handoffs.
Lead, coordinate, and/or participate in initiatives to develop and implement new protocols to improve and optimize handoffs.
Lead, coordinate, and/or participate in evaluation of new strategies or information systems designed to improve handoffs.
ATTITUDES
Hospitalists should be able to:
Recognize the importance and impact of handoff quality on patient safety.
Appreciate the value of real-time interactive dialogue between clinicians during handoffs.
Endorse handoffs as a priority at which time the focus is on transfer of patient care.
Develop and maintain a culture of continued clinician availability should questions arise after the patient handoff.
Adopt an attitude of professional responsibility for all patients who have been received during a handoff.
Patient handoff (also known as handover or sign-out) refers to the specific interaction, communication, and planning required to achieve seamless transitions of care from one clinician to another. Poor handoffs are associated with high rates of self-reported medical errors and adverse events.1-3 Effective and timely handoffs are essential to maintain high-quality medical care, reduce medical errors and redundancy, and prevent loss of information. Hospitalists are involved in the transfer of patient care on a daily basis and can lead institutional initiatives that promote optimal transfer of information between healthcare providers.
Want all 52 JHM Core Competency articles in an easy-to-read compendium? Order your copy now from Amazon.com.
KNOWLEDGE
Hospitalists should be able to:
Describe the key elements of a high-quality patient handoff (shift change or service change).
Explain the components and strategies that are critical for successful communication during handoffs.
List barriers to effective handoff and strategies to mitigate them to improve patient safety.
Describe the factors that influence handoff detail, components, and strategies.
Explain the strengths and limitations of various handoff communication strategies and procedures.
SKILLS
Hospitalists should be able to:
Communicate effectively and efficiently during patient handoff and use appropriate verbal and/or written modalities.
Demonstrate the use of read-back when communicating tasks.
Construct standardized patient summaries for oral and written delivery that permit customization by incorporating the unique characteristics of the patient and his/her diagnosis and treatment plan, healthcare provider, and timing of the handoff.
Evaluate all medications for accuracy regarding indication, dosing, and planned duration before handoff.
Use “if-then” statements for outstanding critical tasks, anticipated events, and any potential complications.
Synthesize clinical information efficiently and request clarification if necessary at the time of handoff receipt.
Update written and verbal handoffs with the most recent clinical information needed for effective transfer of care.
Limit interruptions during handoffs.
Identify the sickest patients and prioritize those for discussion during verbal handoff.
Communicate with patients and families to explain the handoff process and provide advance notification of the change in clinical care team members assuming care for the patient.
Engage stakeholders in institutional initiatives to streamline the incorporation of patient handoffs within clinical workflows and continuously assess the quality of handoffs.
Lead, coordinate, and/or participate in initiatives to develop and implement new protocols to improve and optimize handoffs.
Lead, coordinate, and/or participate in evaluation of new strategies or information systems designed to improve handoffs.
ATTITUDES
Hospitalists should be able to:
Recognize the importance and impact of handoff quality on patient safety.
Appreciate the value of real-time interactive dialogue between clinicians during handoffs.
Endorse handoffs as a priority at which time the focus is on transfer of patient care.
Develop and maintain a culture of continued clinician availability should questions arise after the patient handoff.
Adopt an attitude of professional responsibility for all patients who have been received during a handoff.
1. Horwitz LI, Meredith T, Schuur JD, Shah NR, Kulkarni RG, Jenq GY. Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med. 2009;53(6):701-710.
2. Kitch BT, Cooper JB, Zapol WM, Marder JE, Karson A, Hutter M, et al. Handoffs causing patient harm: a survey of medical and surgical house staff. Jt Comm J Qual Patient Saf. 2008;34(10):563-570.
3. Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121(11):866-872.
1. Horwitz LI, Meredith T, Schuur JD, Shah NR, Kulkarni RG, Jenq GY. Dropping the baton: a qualitative analysis of failures during the transition from emergency department to inpatient care. Ann Emerg Med. 2009;53(6):701-710.
2. Kitch BT, Cooper JB, Zapol WM, Marder JE, Karson A, Hutter M, et al. Handoffs causing patient harm: a survey of medical and surgical house staff. Jt Comm J Qual Patient Saf. 2008;34(10):563-570.
3. Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121(11):866-872.
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