Handing Down the Hand-Off What is a

Handing Down the Hand-Off

What is a Hand. Off? http: //www. flickr. com/photos/cavalierhorn/3938109498/

Why is it important ? Amanda Cegielski http: //www. flickr. com/photos/thatpicturetakr/3148936883/

Variable Odds Ratio for Preventable Adverse Events Cross-Covering Physician 6. 1 APACHE II Score 1. 2 History of GI Bleeding 4. 7 Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Annals of Internal Medicine. 1994; 121(11): 866 -872.

1 2 1 3 1)Frank G, Lawler L, Jackson A, Steinberg T, Lawless S. Resident miscommunication: Accuracy of the resident sign-out sheet. J Healthc Qual. 2005; 27(2). 2)Arora V, Kao J, Lovinger D, Seiden SC, Meltzer D. Medication discrepancies in resident sign-outs and their potential to harm. Journal o general internal medicine. 2007; 22(12): 1751 -1755. 3)Aylward M, Rogers T, Duane P, Inaccuracy in Patient Handoffs: Discrepancies between Resident-Generated Reports and the Medical Record, Minn. Med. 2011; 94(12) 38 -41. Arielle Fragassi http: //www. flickr. com/photos/toastytreat/4555895229/

1 2 1)Kitch BT, Cooper JB, Zapol WM, et al. Handoffs causing patient harm: a survey of medical and surgical house staff. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2008; 34(10): 563570. 2)Horwitz LI, Krumholz HM, Green ML, Huot SJ. Transfers of patient care between house staff on internal medicine wards: a national survey. Archives of Internal Medicine. 2006; 166(11): 1173 -1177. Photo by: Michael Aylward

A Tao of the Hand-Off

Environment Photo by: Michael Aylward

Content 4 P PACE ANTICIPATE AIDET SHARED ASHICE PEDIATRIC SBAR SHARQ HANDOFFS De. MIST STICC 5 P MIST I PASS THE BATON SOAP SIGNOUT GRRRR just go NUTS

Prioritize the patients: Problem Statement: RS=Really Sick Triage S=Sick NS=Not Sick Hand-off should be interactive, with questioning from accepting physician, two-way communication. name, age, sex, significant past medical history, main reason for admissions, highlights/important changes since admission. Tell the Story Details on Demand Problems prioritized, relevant information given within context of person taking the hand-off. Contingency Plans and Concerns

[ If. . . Then ]

Rupert Ganzer http: //www. flickr. com/photos/loop_oh/3294984769

Diagram adapted from Baker DP, Salas E, King H, Battles J, Barach P. The role of teamwork in the professional education of physicians: current status and assessment recommendations. Joint Commission journal on quality and patient safety / Joint Commission Resources. 2005; 31(4): 185 -202

Graphics by Michael Aylward

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