Resources for Improving Patient Handoffs

In 2006, the Joint Commission added transitions in patient care to its National Patient Safety Goals, referencing the need for ‘‘a standardized approach to hand-off communications, including an opportunity to ask and respond to questions.’’ Resident physicians believe transitions are not adequately addressed in education and practice, noting that processes are haphazard, with no system of organized interaction. Limits on resident hours have also increased the use of ‘‘cross-coverage,’’ defined as residents outside of the primary care team providing care in the absence of the primary team. This increase has been associated with an increase in the likelihood of unplanned changes in care and errors attributed to problems with the transfer of information. Visit www.jointcommission.org for more information.

In order to help residents address the issue of handoffs in their residency programs and beyond, the AMA-RFS has compiled the following resources. These resources have been developed by Vineet Arora, MD, an associate professor in the department of medicine and associate director of internal medicine residency at the University of Chicago’s Pritzker School of Medicine. Dr. Arora is one of the nation's leading researchers on patient handoffs.

Educational Videos:

• The Art and Science of Handoffs
• Hospital Handoffs for Intern Orientation
• Attending Supervision: First Day on the Wards
• Handoff Workshop: Two hour training
• Integrating Quality and Patient Safety Education Across the Continuum

Literature and Studies on Handoffs:

• Improving Physician Hand-offs (Nov 2011)
• Useless Charts and Fresh Eyes in Handoffs (Sept 2011)
• Communication Key to Reducing Liability Claims in Patient Handoffs (June 2011)
• A Model for Building a Standardized Hand-off Protocol (Nov 2006)
• Adequacy of Hospital Discharge Summaries in Documenting Tests with Pending Results and Outpatient Follow-up Providers (July 2009)
• Managing Discontinuity in Academic Medical Centers: Strategies for a Safe and Effective Resident Sign-Out (Aug 2006)