Patient handoffs, both within hospitals and elsewhere, are often subject to errors. A 2005 Joint Commission analysis found that 70% of events which resulted in a patient’s death or serious physical/psychological injury were caused by communication breakdowns, half of which occurred during patient handoffs.  Lee Ann Runy [1] writes that The key effective handoffs is to implement processes that clearly define the transfer of responsibility from one caregiver to another, standardize the communication process, and allow for an interactive exchange between the parties involved. The common denominator should always be the patient. Various tools and techniques can be implemented to streamline the handoff process and establish standardised communications. Structured tools e.g. mnemonics, templates or checklists can help to ensure that information is not lost during the handoff, and lead to a timely, accurate exchange of information.
The following are 10 tips for effective patient handoffs:  [1]

  1. Ensure face-to-face patient handoffs whenever possible
  2. Ensure two-way communication during the handoff process
  3. Allow as much time as necessary for handoffs
  4. Use both verbal and written means of communication
  5. Conduct handoffs at the patient bedside whenever possible. Involve patients and families in the handoff process. Provide clear information at discharge
  6. Involve staff in the development of handoff standards
  7. Incorporate communication techniques, such as the SBAR mnemonic (Situation-Background-Assessment-Recommendation), and require a verification process to ensure that information is both received and understood
  8. In addition to information exchange, handoffs should clearly outline the transfer of patient responsibility from one provider to another
  9. Use available technology, such as electronic medical records, to streamline the exchange of timely, accurate information
  10. Monitor use and effectiveness of the handoff and seek ongoing feedback from staff members.

[1] R10938 Runy, L. A., (2008), Patient Handoffs, Hospitals & Health Networks, Vol 82, Iss 5, pp 41-47, Health Forum Inc., Chicago

Neil Crawford


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