Improving handoffs in the emergency department.
Patient handoffs at shift change are a ubiquitous and potentially hazardous process in emergency care. As crowding and lengthy evaluations become the standard for an increasing proportion of emergency departments (EDs), the number of patients handed off will likely increase. It is critical now more than ever before to ensure that handoffs supply valid and useful shared understandings between providers at transitions of care. The purpose of this article is to provide the most up-to-date evidence and collective thinking about the process and safety of handoffs between physicians in the ED. It offers perspectives from other disciplines, provides a conceptual framework for handoffs, and categorizes models of existing practices. Legal and risk management issues are also addressed. A proposal for the development of handoff quality measures is outlined. Practical strategies are suggested to improve ED handoffs. Finally, a research agenda is proposed to provide a roadmap to future work that may increase knowledge in this area.
Sky Ridge Medical Center, Carepoint P.C., 5600 South Quebec Street, Greenwood Village, CO 80111, USA. dscheung@alum.mit.edu
Dickson S
DS
Cheung
John J
JJ
Kelly
Christopher
C
Beach
Ross P
RP
Berkeley
Robert A
RA
Bitterman
Robert I
RI
Broida
William C
WC
Dalsey
Heather L
HL
Farley
Drew C
DC
Fuller
David J
DJ
Garvey
Kevin M
KM
Klauer
Lynne B
LB
McCullough
Emily S
ES
Patterson
Julius C
JC
Pham
Michael P
MP
Phelan
Jesse M
JM
Pines
Stephen M
SM
Schenkel
Anne
A
Tomolo
Thomas W
TW
Turbiak
John A
JA
Vozenilek
Robert L
RL
Wears
Marjorie L
ML
White
D003142:Communication; D003266:Continuity of Patient Care; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D017146:Models, Organizational; D012308:Risk Management / Q000379:methods / Q000458:organization & administration; D014481:United States