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Handoff Safety Curriculum

This curriculum focuses on improving safety during patient handoffs in healthcare settings. It highlights the critical role of effective communication and the potential for medical errors due to poor handoffs. Participants will review the importance of standardized approaches to handoffs, observe case scenarios, and practice both verbal and written handoff techniques. Key topics include minimizing interruptions, using clear formats, and facilitating receiving providers' understanding through discussions and recap summaries. A comprehensive approach ensures better patient care and continuity.

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Handoff Safety Curriculum

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  1. Handoff Safety Curriculum HUP Department Date

  2. “Handoffs and Sign-Out”Verbal and Written • Review the importance of handoffs • Watch and critique videos of handoffs • Teach the components of safe written and verbal handoffs • Formal post-didactic observed handoffs

  3. This is why… • Poor communication is the most common cause of medical errors nationally • JCAHO: 2006 National Patient Safety Goal requiring hospitals to implement standardized approach to patient handoffs • HUP Provider Survey: 70 Surgery, 35 Medicine, 25 Emergency, 23 NP/PAs • HUP GME 2012: Mandatory handoff curriculum and assessment for all new resident hires

  4. Video Handoff Example: Good or Bad?

  5. Case Scenario • Department specific

  6. Keys to Good Verbal Handoffs • Location, location, location • As quiet as possible • Minimize interruptions • If you are worried about the patient…say it! • Give receiving provider an opportunity to ask questions and repeat back important facts • Review every patient • Follow the same format/order for all patients

  7. SHOUT… it Out! S – Sick or Not Sick (include DNR, diagnosis) H – History and Hospital Course O – Objective Data (exam, vitals, results) U – Upcoming Plan, Dispo T – To Do (include rationale) Acronym modeled after Arora, V., et. al.

  8. Covering Provider As a reminder, it is the responsibility of the incoming provider to sign in as the new covering provider after verbal handoff

  9. Keys to a Good Written Signout • Standardize • Exclude irrelevant or outdated information • Update sign-out before every handoff!!! • Avoid non-standard abbreviations • Summarize findings. Do not cut and paste every result.

  10. The “Checklist” Q11: How much information does the written/printed sign-out have? N = 124 respondents • Procedures • Diet and NPO orders • Acuity level • Code status, allergies, and contact • Recent VS, Labs, Exam • Antibiotic information • Infectious history • Updated problem list, correctly prioritized • Brief summary of hospital course • Important medication information • 24-48 care plan • Recap of recent/same day events • Med changes, procedures, clinical changes • Better anticipatory guidance % of Total Too much (10) Not enough (8) Right amount (40) Variable (66)

  11. Keys to a Good Written Sign-out

  12. Summary of “Best Practices” in Handoffs • Quiet Location • Minimize Interruptions • Standardize both written and verbal format as much as possible • Use anticipatory guidance and avoid anchoring bias • Make time for questions and clarifications

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