Mutual Matters

Improving Handoffs, Improving Patient Safety

Posted by Guest Writer on Oct 7, 2016 12:35:00 PM

Handoffs are a necessary part of patient care.  These transfers of information, authority and responsibility occur whenever a provider changes, when a patient is transferred from one unit to another, before and after a procedure, and at admission and discharge. 

Handoffs account for a disproportionate number of patient safety events.  According to a Joint Commission analysis communication errors account for nearly 70% of sentinel events and at least half of these errors occur during handoffs.

Given the importance of handoff communication what are some methods providers can use to improve communication during handoffs and ensure patient safety? Here are a few ideas:

  • Determine what will trigger a handoff. Obvious times for a handoff include a shift change or a patient move to a different unit. Other opportunities for handoffs include critical diagnostic test results, a physician to nurse handoff, whenever an event, such as the Rapid Response Team activation, occurs for a patient.
  • Ensure adequate time for handoffs. Time should be set aside and protected for communication of handoff information. This time should be consistent; it could be five minutes before the change of a shift, whenever a patient leaves the unit for a diagnostic study, whenever a patient is admitted, etc. Whatever the time or triggering event chosen, it should be consistently applied.
  • Ensure adequate space for handoffs. Handoffs should optimally be done face-to-face, in a quiet setting that promotes giving and receiving important information.  While the face-to-face handoff with written material is the gold standard, there may be times when it is not possible and other methods, such as email, texting, computer generated documents or the EHR must be used in the handoff.  If this is the case, confirmation that critical information was received and understood must be obtained.

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Created by MagMutual from materials provided by COPIC as part of MagMutual and COPIC’s alliance to improve patient safety and quality of care for all of our PolicyOwners.


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