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Tips for High-quality Hand-offs

Nurse assisting person with crutches

The transfer of care of a patient from one provider to another is commonly referred to as hand-off and is an essential part of communicating history, concerns, and tasks that need to be completed for patient safety and timely treatment.  Failure in this communication can lead to patient risk of harm and medical errors (Angelow & Specht, 2019).

A common tool used to guide the communication of these key pieces of information is the SBAR tool, which stands for and is defined by the Joint Commission as:

  • Situation – clearly and briefly define the situation
  • Background – provide clear, relevant and background information that relates to the situation
  • Assessment – a statement of your professional conclusion
  • Recommendation – what do you need from the receiving individual

Angelow & Specht (2019), wrote an article in the Journal of Legal Nurse Consulting, referencing the Joint Commission’s “Eight tips for effective handoffs”, these include:

  1. Determine the critical information that needs to be communicated
  2. Standardize tools and methods used to communicate to receivers
  3. Don’t rely solely on electronic or paper communications
  4. If information is coming from many sources, combine and communicate it all at one time
  5. Make sure the receiver gets the following minimum information:
    • sender contact info
    • illness assessment
    • patient summary
    • to-do action list
    • contingency plan
    • allergy list
    • code status
    • medication list
    • dated lab tests
    • dated vital signs
  6. When conducting hand-offs or sign-outs, do them face to face in a designated location that is free of non-emergency interruptions
  7. When conducting a hand-off include all team members and, if appropriate, patient and family
  8. Use electronic health records and other technologies to enhance hand-offs between senders and receivers

For more information of the Legal Aspects of Patient Handoff, see the Journal of Legal Nurse Consulting

References

Angelow, Anthony & Specht, Dawn (2019). The Journal of Legal Nurse Consulting: Legal aspects of patient handoff in the emergency department, 30(2), p. 14-18.  Retrieved from http://www.aalnc.org/page/journal-v2.0

The Joint Commission (2013). SBAR – a powerful tool to help improve communication!  Retrieved from https://www.jointcommission.org/resources/news-and-multimedia/blogs/at-home-with-the-joint-commission/2013/11/sbar–a-powerful-tool-to-help-improve-communication/

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