A standardized handoff program can reduce medical errors and can be replicated at hospitals across the country, says the lead researcher of a new study published in JAMA.
Researchers reviewed the medical literature for successful handoff-intervention programs that they could teach to residents and senior interns working within two units at Boston Children’s Hospital. They ultimately settled on a bundle that included standardized communication and handoff training, a verbal mnemonic to help staff members remember what information to pass off to the next team, and a handoff structure that involved junior and senior physicians meeting in a quiet room to discuss the handoff. In addition, on one unit, residents used a computerized tool linked to the electronic medical record that made it easier for them to pass along important information about the patient.
The analysis included 642 handoffs that occurred before the intervention and 613 that happened afterwards. Researchers found that medical errors decreased from 33.8 per 100 admissions (95% CI, 27.3–40.3) prior to the intervention to 18.3 per 100 admissions (95% CI, 14.7–21.9; P?P=0.04).
Amy Starmer, MD, MPH, associate scientific researcher at Boston Children’s Hospital and lecturer in pediatrics at Harvard Medical School in Boston, says that when implementing an intervention program, it’s important to involve staff from all levels of the hospital.
“We thought carefully about who should be able to make transformational change happen,” says Dr. Starmer. “That included resident program directors, educators, attending physicians who help observe the residents, and senior administrative people in the hospital who knew this was going on and were supportive. Even the technology team was able to devote programming support and resources to allow the development of a computerized tool.”