Vineet Arora, MD, FHM, has had extensive experience in patient handoffs, and highlighted the importance of handoffs for the transfer of patient information in a Monday afternoon breakout session at HM12. Safe and successful handoffs include several steps for the transfer of information, said Dr. Arora. These steps include pre-handoff, the arrival of the incoming physician, dialogue, and post-handoff.
Effective handoffs strategies include standardized information, updated information, limited interruptions, and specific structure including read-backs. Face-to-face handoffs are ideal.
- Beware of egocentric heuristic, the assumption that the receiving physician has the exact same information and fund of knowledge as the initial or sending physician.
- Checklists can be helpful but can have flaws when not used appropriately.
- “If-then” and “to do” lists are the most retained form of information from handoffs.
- Prioritize the most-ill patients during handoffs.
- Assess receiver understanding.
- Beware of too much information during handoffs.
- Programatic changes, such as protected handoff time and space, can support proper handoffs.