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Effective Handoffs Strategies Highlighted at HM12

The Hospitalist. 2012 April;2012(04):

Vineet Arora, MD, FHM, has had extensive experience in patient handoffs, and highlighted the importance of handoffs for the transfer of patient information in a Monday afternoon breakout session at HM12. Safe and successful handoffs include several steps for the transfer of information, said Dr. Arora. These steps include pre-handoff, the arrival of the incoming physician, dialogue, and post-handoff.

Effective handoffs strategies include standardized information, updated information, limited interruptions, and specific structure including read-backs. Face-to-face handoffs are ideal.

Takeaways

  • Beware of egocentric heuristic, the assumption that the receiving physician has the exact same information and fund of knowledge as the initial or sending physician.
  • Checklists can be helpful but can have flaws when not used appropriately.
  • "If-then" and "to do" lists are the most retained form of information from handoffs.
  • Prioritize the most-ill patients during handoffs.
  • Assess receiver understanding.
  • Beware of too much information during handoffs.
  • Programatic changes, such as protected handoff time and space, can support proper handoffs.