title: Handoff strategies in settings with high consequences for failure: lessons for health care operations.
abstract: OBJECTIVE
  To describe strategies employed during handoffs in four settings with high consequences for failure.
  
  
  METHODS
  
  
  
  METHODS
  of observational data for evidence of use of 21 handoff strategies.
  
  
  METHODS
  NASA Johnson Space Center in Texas, nuclear power generation plants in Canada, a railroad dispatch center in the United States, and an ambulance dispatch center in Toronto.
  
  
  METHODS
  Evidence of 21 handoff strategies from observations and interviews.
  
  
  RESULTS
  Nineteen of 21 strategies were used in at least one domain, on at least an 'as needed' basis.
  
  
  CONCLUSIONS
  An understanding of how handoffs are conducted in settings with high consequences for failure can jumpstart endeavors to modify handoffs to improve patient safety.
authors.affiliation: Veteran's Administration Getting at Patient Safety (GAPS) Center, Cincinnati, OH 43210, USA. patterson.150@osu.edu
authors.forename: Emily S
authors.initials: ES
authors.lastname: Patterson
authors.forename: Emilie M
authors.initials: EM
authors.lastname: Roth
authors.forename: David D
authors.initials: DD
authors.lastname: Woods
authors.forename: Renée
authors.initials: R
authors.lastname: Chow
authors.forename: José Orlando
authors.initials: JO
authors.lastname: Gomes
mesh_terms: D002170:Canada; D058016:Health Facility Administration; D033181:Information Dissemination; D019982:Organizational Case Studies; D017149:Private Sector; D012306:Risk; D012449:Safety; D014481:United States