title: Interunit handoffs of patients and transfers of information: a survey of current practices.
abstract: OBJECTIVE
  We describe the current state of emergency department to inpatient handoffs and assess handoff best practices between emergency physicians and hospitalist medicine physicians.
  
  
  METHODS
  A survey was distributed electronically to emergency medicine and internal medicine physicians at 10 hospitals across the United States. Descriptive and quantitative analysis was performed on survey results. Additionally, qualitative data were obtained from an expert focus group of both emergency medicine and hospital medicine clinicians.
  
  
  RESULTS
  Seven hundred fifty of 1,799 physicians (42.2%) responded to our Web-based survey. Attending physicians (45%) described themselves as practicing emergency medicine (51%) or internal medicine (56%). Responding residents were 55% internal medicine, 43% emergency medicine, and 13% dual emergency medicine/internal medicine. Of the responding departments, use of standardized tools was reported by less than 20% and only one third of residents reported formal handoff training. Handoff factors identified as important include identifying "high-risk" patients, designating uninterrupted time to perform the handoff, and standardizing information provided during the handoff. Qualitative results mirrored these themes and acknowledged the importance of bedside handoffs.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest multispecialty survey to date, including both resident and attending physicians in emergency medicine and hospital medicine. Standardized tools are rarely used and training of residents in this critical task is uncommon. Physicians in both specialties agree on the important content and structure of handoff, including the ideal situation of face-to-face bedside discussion. A curriculum and assessment tool for this practice should be developed.
authors.affiliation: Durham VA Medical Center and Duke University School of Medicine, Durham, NC.
authors.forename: Chad
authors.initials: C
authors.lastname: Kessler
authors.affiliation: Hennepin County Medical Center, Departments of Emergency Medicine and Internal Medicine, and the University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Scott
authors.affiliation: University of Illinois Hospital and Health Sciences System, and the University of Illinois Chicago College of Medicine, Departments of Emergency Medicine and Internal Medicine, Chicago, IL.
authors.forename: Matt
authors.initials: M
authors.lastname: Siedsma
authors.affiliation: Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, CA, and the David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Jordan
authors.affiliation: Department of Emergency Medicine, Northwestern University-The Feinberg School of Medicine, Chicago, IL.
authors.forename: Christopher
authors.initials: C
authors.lastname: Beach
authors.affiliation: Christiana Care Health System, Departments of Emergency and Internal Medicine, Newark, DE. Electronic address: ccoletti@christianacare.org.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Coletti
mesh_terms: D001291:Attitude of Health Personnel; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D019538:Health Care Surveys; D020445:Hospitalists; D006801:Humans; D007297:Inpatients; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D062209:Patient Handoff / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D014481:United States