title: Exploring information chaos in community pharmacy handoffs.
abstract: BACKGROUND
  A handoff is the process of conveying necessary information in order to transfer primary responsibility for providing safe and effective drug therapy to a patient from one community pharmacist to another, typically during a shift change. The handoff information conveyed in pharmacies has been shown to be unstructured and variable, leading to pharmacist stress and frustration, prescription delays, and medication errors.
  
  
  OBJECTIVE
  The purpose of this study was to describe and categorize the information hazards present in handoffs in community pharmacies.
  
  
  METHODS
  A qualitative research approach was used to elicit the subjective experiences of community pharmacists. Community pharmacists who float or work in busy community pharmacies were recruited and participated in a face to face semi-structured interview. Using a systematic content data analysis, the study identified five categories of information hazards that can lead to information chaos, a framework grounded in human factors and ergonomics.
  
  
  RESULTS
  Information hazards including erroneous information and information overload, underload, scatter, and conflict, are experienced routinely by community pharmacists during handoff communication and can result in information chaos. The consequences of information chaos include increased mental workload, which can precipitate problematic prescriptions "falling between the cracks." This can ultimately impact patient care and pharmacist quality of working life.
  
  
  CONCLUSIONS
  The results suggest that handoffs in community pharmacies result in information hazards. These information hazards can distract pharmacists from their primary work of assessing prescriptions and educating their patients. Further research on how handoffs are conducted can produce information on how hazards in the system can be eliminated.
authors.affiliation: School of Pharmacy, University of Wisconsin - Madison, 2513 Rennebohm Hall, 777 Highland Ave., Madison, WI 53705, USA. Electronic address: mchui@pharmacy.wisc.edu.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Chui
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Stone
mesh_terms: D003142:Communication; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008508:Medication Errors / Q000706:statistics & numerical data*; D005791:Patient Care / Q000592:standards; D062209:Patient Handoff / Q000458:organization & administration* / Q000592:standards; D010561:Personnel Staffing and Scheduling; D010595:Pharmacists / Q000458:organization & administration* / Q000523:psychology / Q000592:standards; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D016526:Workload
keywords: Community pharmacy; Handoffs; Human factors; Medication safety