title: Handoffs and Patient Safety: Grasping the Story and Painting a Full Picture.
abstract: Effective handoff communication is critical for patient safety. Research is needed to understand how information processes occurring intra-shift impact handoff effectiveness. The purpose of this qualitative study was to examine medical-surgical nurses' (n = 21) perspectives about processes that promote and hinder patient safety intra-shift and during handoff. Results indicated that offgoing nurses' ability to grasp the story intra-shift was essential to convey the full picture during handoff. When oncoming nurses understood the picture being conveyed at the handoff, nurses jointly painted a full picture. Arriving and leaving the handoff with this level of information promoted patient safety. However, intra-shift disruptions often impeded nurses in their processes to grasp the story thus posing risks to patient safety. Improvement efforts need to target the different processes involved in grasping the story and painting a full picture. Future research needs to examine handoff practices and outcomes on units with good and poor practice environments.
authors.affiliation: San Francisco Veterans Affairs Medical Center, USA Patricia.Birmingham@va.gov.
authors.forename: Patricia
authors.initials: P
authors.lastname: Birmingham
authors.affiliation: San Francisco Veterans Affairs Medical Center, USA University of California, San Francisco, USA.
authors.forename: Martha D
authors.initials: MD
authors.lastname: Buffum
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Blegen
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Audrey
authors.initials: A
authors.lastname: Lyndon
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D066296:Grounded Theory; D006801:Humans; D008875:Middle Aged; D009726:Nurses / Q000592:standards*; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D010465:Perception
keywords: continuity of care; handoff; handover; shift report