Happy Handoffs The Cornerstone of Success

for Residency in the Modern Age

Happy Handoffs Lecture outline slide

What is a handoff Communication…

Depends on the communicator’s clinical experience (blueprint)

Why are Handoffs so important?

More time ‘passing the baton’

Multiple handoffs for each patient daily due to the team based approach to patient care versus single provider

In 2010 Joint Commission added handoff into Accreditations Standards (Blueprint article)

We are all on the same ‘team’

There is no ‘my patient – your patient’. We are all responsible for the patient at any given time

What are the goals of each handoff

Discussion of plan of care with the team Minimize disruptions in continuity of care Emphasize patient safety

NOT a one-way street for passive communication (blueprint)

What happens if handoffs are not effective

Adverse events

Longer hospital stays

Increased cost of patient care

High risk situations: Patient critical/unstable, transitions of primary caregiver, first time listener is learning about patient (blueprint)

No doctor is an island

Some residents may feel that they should personally complete certain tasks

Attendings may perpetuate this ideology (‘when I was a resident…”)

Understanding when it is appropriate and when it is not appropriate to hand off patient care is one of the more difficult skills learned during internship

The impact of EMR on handoffs

EMR supported handoff tools will become more widespread

On the record versus off the record Questions of liability Multidisciplinary editing of the EMR handoff

Cross Cover Tips

What to include in written handoff

What to say during verbal handoff

The Handoff Environment