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Handoff improvement: we need to understand what we are trying to fix.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Eaton, Erik G. Van |
| Copyright Year | 2010 |
| Abstract | Improvement from Front Office to Front Line " The wide diversity of handoff quality measures suggests a lack of consensus about the primary purpose of handoffs and how best to intervene to improve handoff processes. " —Patterson and Wears (page 59) Editorial T oo often in the hospital, we hear that important information or tasks " just fell through the cracks " after a transfer of patient care. Yet this analogy is wrong. The problem with transfer of patient care is that it is not a clear pathway with some dangerous cracks that need fixing. Patient handoffs in medicine are astonishingly variable , 1,2 with no prespecified purpose or structure other than to " maintain continuity of care " or to provide enough input to the next care area to support a good outcome. Most residents are not trained in handoffs and learn the technique by modeling equally unskilled peers. It's no wonder the process is called a " peculiar ritual " 3 —unscientific repetitive behavior with no guaranteed outcome. In this issue of The Joint Commission Journal on Quality and Patient Safety, Patterson and Wears expose this uncertainty and complexity in a review that explores all the objectives that inpa-tient handoffs could accomplish. 4 These researchers, mindful of clinical needs, group these functions into seven categories, or fram-ings, and suggest outcome measures for each framing. Those interested in improving handoffs will realize after reading the article that we cannot simply " improve handoffs " with a checklist or some training. We must instead review our handoff processes. Relevant improvement will only come after understanding that different clinical scenarios require different handoffs. Each handoff must be reviewed, dominant framings discovered, and changes thoughtfully designed to fit work flow and be measurable. Several of the authors' measures are things that care providers do or remember during busy clinical work. Those who use this review's important framework in a careful handoff redesign must beware of focusing too many interventions on the workers at the sharp end while failing to overhaul handoff conditions and supporting tools that are created in the organization's upper echelons—where more lasting improvements ought to be made. An example of one such supporting tool is described in the article by Anderson et al., also in this issue. 7 This software application provides a readable, reliable, and complete, yet not overwhelming, supply of information from an outgoing care provider to … |
| Starting Page | 51 |
| Ending Page | 51 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/s1553-7250(10)36010-7 |
| PubMed reference number | 20180436 |
| Journal | Medline |
| Volume Number | 36 |
| Issue Number | 2 |
| Alternate Webpage(s) | http://www.handover.eu/upload/library/gv2g0z55seiol04iqcvai.pdf |
| Alternate Webpage(s) | http://handover.cmj.org.pl/upload/library/gv2g0z55seiol04iqcvai.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/s1553-7250%2810%2936010-7 |
| Journal | Joint Commission journal on quality and patient safety |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
