1. Implementation of an evidence-based, standardized intervention for transfer of patient care (patient handoffs) reduced handoff errors by 69% over the year-long study period.
2. Clinician satisfaction with the transfer of care process increased significantly from 55% to 70%.
Evidence Rating Level: 2 (Good)
Study Rundown: Patient handoffs occur during hospital shift changes and the movement of a patient between different units. During handoffs, the responsibility of care and patient treatment are transferred from one health care provider to another. This must be done efficiently in order to maintain patient health and safety. This study sought to evaluate a standardized, evidence-based method for handoffs and transfer of patient care in children’s hospitals. Initially, 25.8% of all handoffs contained errors, but failures were reduced by a total of 69% over a year’s time after the implementation of a standardized handoff process across multiple hospitals. Handoff satisfaction among clinicians increased by 15% during the study period. Results may be limited by the inability to control for bias (Hawthorne effect), variation in method of data collection by site, and results did not directly measure harm to patients. Nonetheless, these findings may encourage medical institutions to create and implement standardized handoff processes to reduce medical error.
Relevant Reading: Assessing the quality of patient handoffs at care transitions
In-Depth: A total of 23 hospitals from the Child Health Corporation of America (CHCA) participated in this year-long study, in which an evidence-based, pediatric-specific handoff method which was adapted to each institution. Handoffs were evaluated 4 to 8 hours after their completion by interviews conducted with the clinician who assumed responsibility for the patient’s care. A total of 7864 handoffs were evaluated during the study period. Errors during handoff were defined by a failure in information transfer that directly affected, delayed, or complicated patient care. Handoff failures decreased significantly from 25.8% (95% CI: 23.9-27.8), to 7.9% (CI: 6.8-9.2; p < .05) after the intervention. Significant reductions in error were observed in each handoff situation studied (e.g. shift to shift, emergency department to inpatient unit, etc…). Total compliance to all elements of the standardized handoff process improved significantly from 87% to 94% (CI: 91-96; p < .05) and clinician satisfaction with the handoff process increased significantly from 55% to 70% (CI: 68-72; p < .05).
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