![]() Lack of resources to implement handoff program 1,3 Lack of time, inability to follow up or share additional information 2-5 Handoff tools help clinicians gather needed information and pass it on to other healthcare workers, but this integral part of coordinating patient care can fail. Synthesis by receiver), and for clinical and nonclinical staff, the “ticket to ride” tool, used when transporting patients. Situation awareness and contingency planning, and Examples of some well-known handoff tools for clinicians include SBAR ( Situation, 10-15 Healthcare professionals have developed and validated a variety of handoff tools that provide a shared mental model to help complete a patient handoff. The literature is replete with articles focusing on the use of handoff tools. Effective handoffs require teamwork, shared practices, and shared expectations (e.g., use of handoff tools). For example, hospital intensive care units may adhere to handoff criteria that differ from obstetric unit criteria. ![]() ![]() 5-7 The challenge in completing a successful handoff is knowing what information is most important and how to convey the information in a clear and concise manner appropriate for the patient’s circumstances. 4 Good communication is a part of patient care and leadership standards. The Joint Commission identified communication as the third most frequently identified root cause for a sentinel event in 20. Handoffs between healthcare workers occur hundreds to thousands of times each day, creating opportunities to identify effective handoff communications. 3 Lapses in handoffs impact all groups of healthcare clinicians (e.g., physicians, nurses, allied health professionals) and nonclinicians (e.g., transportation staff). In a study by Tucker and Edmondson, missing or incorrect information was one of five broad types of healthcare problems or process failures encountered by nurses. In cases in which information is incomplete or a handoff fails to occur, an incomplete understanding of a patient’s condition may contribute to inappropriate or inadequate treatment. When a handoff is successfully completed, the next person responsible for the patient has the necessary information to inform care for that specific patient. Each handoff provides opportunities to catch and correct errors. They occur at change of shift (e.g., attending physicians, nursing staff), transfer of patients from one area within a healthcare facility to another, transfers between facilities, and during shifts when staff leave the unit or area to tend to other patients or take a break. 1 Handoff communications coordinate patient care by passing essential information about a patient’s health status and responsibility for the patient’s care from one healthcare worker to another. Handoffs involve sharing patient information and often include performing a visual inspection of the patient to confirm the accuracy of information conveyed. Personnel at a Pennsylvania healthcare facility contacted the Pennsylvania Patient Safety Authority to learn about the types of handoff-related events reported by other facilities in the state so they could adapt and improve their handoff processes. Using handoff processes that incorporate critical thinking and reasoning skills to address patient needs, addressing environmental distractions and communication deficits, and providing handoff training and education are strategies to improve patient handoff communications. In addition, about 20% of the event reports stated that there was no handoff given and in another 16% of the event reports, details about the patient’s condition were omitted from the handoff. About 60% of the handoff reports indicated discrepancies between information shared and the patient’s condition noted during or after a handoff with no description of a follow up in 40% of the event reports, a follow up in patient care to address the discrepancy was stated. In Pennsylvania, facilities reported 1,565 handoff-related events through the Pennsylvania Patient Safety Reporting System (PA-PSRS) that occurred in 20. Effective handoffs have multiple functions: transferring responsibility and accountability for the patient’s care and confirming the accuracy of information from one healthcare worker to another and providing opportunities to catch and correct errors. Handoffs are an integral part of care coordination and the delivery of safe patient care. Pennsylvania Patient Safety Authority Abstract
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