title: Transfer of accountability: transforming shift handover to enhance patient safety.
abstract: Communication of information between healthcare providers is a fundamental component of patient care. The information shared between providers who are changing shifts, referred to as "handover," helps plan patient care, identifies safety concerns and facilitates continuity of information. Absent or inaccurate information can have deleterious effects on patient care. According to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO 2003), almost 70% of all sentinel events are caused by breakdown in communication. Issues and concerns regarding the effectiveness of handover at shift change were raised by nurses throughout Hamilton Health Sciences (HHS), leading to the approval of a hospital-wide project to implement evidenced-based Transfer of Accountability (TOA) Guidelines and a bedside patient safety checklist. This article describes the development of the guidelines, the results of the pilot study and the ongoing implementation of the project. The observed impact on patient safety within HHS is presented.
authors.affiliation: Henderson and Chedoke Hospitals, Hamilton Health Sciences, ON, Canada. alvarkim@hhsc.ca
authors.forename: Kim
authors.initials: K
authors.lastname: Alvarado
authors.forename: Ruth
authors.initials: R
authors.lastname: Lee
authors.forename: Emily
authors.initials: E
authors.lastname: Christoffersen
authors.forename: Nancy
authors.initials: N
authors.lastname: Fram
authors.forename: Sheryl
authors.initials: S
authors.lastname: Boblin
authors.forename: Nancy
authors.initials: N
authors.lastname: Poole
authors.forename: Janie
authors.initials: J
authors.lastname: Lucas
authors.forename: Shirley
authors.initials: S
authors.lastname: Forsyth
mesh_terms: D003142:Communication; D006801:Humans; D009096:Multi-Institutional Systems; D009864:Ontario; D019982:Organizational Case Studies; D010360:Patient Transfer / Q000458:organization & administration*; D017751:Safety Management; D012941:Social Responsibility