Tips to improve patient handoffs, outcomes

Hospitals can take several steps to reduce handoff errors, according to a new study published in Pediatrics.

Done wrong, handoffs can leave doctors and nurses ill-informed about tests, diagnoses or medication needs for the patients whose care they take over, according to the researchers, led by Paul Sharek, M.D., medical director of quality management and chief clinical patient safety officer at Lucile Packard Children's Hospital Stanford in Connecticut.

Sharek and his team conducted a one-year study of 23 pediatric hospitals around the country and discovered a significant decline in handoff-related care errors in hospitals where the process was standardized. Measuring both shift changes and patient transfers hospital department by hospital department, researchers found the rate of handoff-related care failures dropped from a baseline of approximately 25 percent to roughly 8 percent.

"Surprisingly, this manuscript was amongst the first of its kind to actually show a decrease hand-off-related care failures," Sharek told Stanford Medicine's blog Scope.

The secret behind the hospitals' improvement was clearly defining every element of the handoff, including each interaction's intent, process, content and team leadership, according to researchers. Sharek's team identified several key factors for handoff quality, including:

  • Active participation among both receiving and sending teams

  • Clearly defined opportunities for receiving teams to ask questions or clarify

  • A universal script for all key handoff elements

  • A summary of  basic issues and further steps for each patient

Overall, according to researchers, caregivers said they were happy with the standardized process and wanted to buy into it long-term. "Given the increasing recognition of the risk of hand-offs in healthcare, these findings reassure us that large-scale improvements in hand-off safety can be achieved rapidly," researchers wrote.

A December study in the Journal of the American Medical Association on standardized communication during handoffs came to similar conclusions. The system used in the study included three components: standardized communication and handoff training, a restructured team handoff process and a verbal mnemonic, FierceHealthcare previously reported.

To learn more:
- read the study abstract
- read the blog post

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