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.
Cheung
Dickson S
DS
Sky Ridge Medical Center, Carepoint P.C., 5600 South Quebec Street, Greenwood Village, CO 80111, USA. dscheung@alum.mit.edu
Kelly
John J
JJ
Beach
Christopher
C
Berkeley
Ross P
RP
Bitterman
Robert A
RA
Broida
Robert I
RI
Dalsey
William C
WC
Farley
Heather L
HL
Fuller
Drew C
DC
Garvey
David J
DJ
Klauer
Kevin M
KM
McCullough
Lynne B
LB
Patterson
Emily S
ES
Pham
Julius C
JC
Phelan
Michael P
MP
Pines
Jesse M
JM
Schenkel
Stephen M
SM
Tomolo
Anne
A
Turbiak
Thomas W
TW
Vozenilek
John A
JA
Wears
Robert L
RL
White
Marjorie L
ML
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