Improving Handoffs in the Emergency Department

Patient handoffs at shift change are a ubiquitous and potentially hazardous process in emergency care. As crowding and lengthy evaluations become the standard for an increasing proportion of emergency departments (EDs), the number of patients handed off will likely increase. It is critical now more...

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Veröffentlicht in:	Annals of emergency medicine 2010-02, Vol.55 (2), p.171-180
Hauptverfasser:	Cheung, Dickson S., MD, MBA, MPH, Kelly, John J., DO, Beach, Christopher, MD, Berkeley, Ross P., MD, Bitterman, Robert A., MD, JD, Broida, Robert I., MD, Dalsey, William C., MD, MBA, Farley, Heather L., MD, Fuller, Drew C., MD, MPH, Garvey, David J., PhD, MD, Klauer, Kevin M., DO, McCullough, Lynne B., MD, Patterson, Emily S., PhD, Pham, Julius C., MD, PhD, Phelan, Michael P., MD, JD, Pines, Jesse M., MD, MBA, MSCE, Schenkel, Stephen M., MD, MPP, Tomolo, Anne, MD, MPH, Turbiak, Thomas W., MD, Vozenilek, John A., MD, Wears, Robert L., MD, MS, White, Marjorie L., MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Communication Continuity of Patient Care Efficiency, Organizational Emergency Emergency and intensive care: techniques, logistics Emergency Service, Hospital - organization & administration Humans Intensive care medicine Intensive care unit. Emergency transport systems. Emergency, hospital ward Interprofessional Relations Medical sciences Models, Organizational Risk Management - methods Risk Management - organization & administration United States
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Beschreibung
Zusammenfassung:	Patient handoffs at shift change are a ubiquitous and potentially hazardous process in emergency care. As crowding and lengthy evaluations become the standard for an increasing proportion of emergency departments (EDs), the number of patients handed off will likely increase. It is critical now more than ever before to ensure that handoffs supply valid and useful shared understandings between providers at transitions of care. The purpose of this article is to provide the most up-to-date evidence and collective thinking about the process and safety of handoffs between physicians in the ED. It offers perspectives from other disciplines, provides a conceptual framework for handoffs, and categorizes models of existing practices. Legal and risk management issues are also addressed. A proposal for the development of handoff quality measures is outlined. Practical strategies are suggested to improve ED handoffs. Finally, a research agenda is proposed to provide a roadmap to future work that may increase knowledge in this area.
ISSN:	0196-0644 1097-6760
DOI:	10.1016/j.annemergmed.2009.07.016