Standardizing Handoff Procedures to Improve Patient Safety

After identifying various issues related to patient handoffs at its institution, one hospital embarked on a facility-wide standardization of handoff procedures, which it detailed in an article published in the October 2012 issue of BMJ Quality and Safety. When reviewing the facility’s handoff procedures, the multispecialty team found that there were various issues within each specialty but also noted that there were three common gaps for all: (1) poorly written documentation that was not always consistent with privacy regulations, (2) lack of training and evaluation related to handoffs, and (3) lack of standard policies. Previously, the patient sign-out notes were “often illegible or contained minimal information” and were written on local workstations; patient information was also being saved into spreadsheets on memory sticks and passed among physicians. Seeking to end these practices, the organization created a common format for the sign-out note, incorporating a few fields for different specialties. Only one sign-out note could be created for each specialty, and all team members, including nurses and social workers, could enter information into the note. The sign-out note was embedded into the facility’s electronic medical record (EMR) system.