TY - JOUR
T1 - Variation in printed handoff documents
T2 - Results and recommendations from a multicenter needs assessment
AU - I-PASS Study Education Executive Committee
AU - Rosenbluth, Glenn
AU - Bale, James F.
AU - Starmer, Amy J.
AU - Spector, Nancy D.
AU - Srivastava, Rajendu
AU - West, Daniel C.
AU - Sectish, Theodore C.
AU - Landrigan, Christopher P.
AU - Noble, Elizabeth L.
AU - Tse, Lisa L.
AU - O'Toole, Jennifer K.
AU - Coffey, Maitreya
AU - Destino, Lauren A.
AU - Everhart, Jennifer L.
AU - Patel, Shilpa J.
AU - Hepps, Jennifer H.
AU - Lopreiato, Joseph O.
AU - Yu, Clifton E.
AU - Sessions Cole, F.
AU - Calaman, Sharon
AU - Kahana, Madelyn D.
AU - McGregor, Robert S.
AU - Webster, John S.
AU - Allen, April D.
AU - Feraco, Angela M.
AU - Dalal, Anuj K.
AU - Keohane, Carol A.
AU - Lipsitz, Stuart
AU - Rothschild, Jeffrey M.
AU - Wien, Matt F.
AU - Yoon, Catherine S.
AU - Zigmont, Katherine R.
AU - Gonzalez del Rey, Javier
AU - Solan, Lauren G.
AU - Aylor, Megan E.
AU - Wagner, Tamara
AU - Bismilla, Zia
AU - Mahant, Sanjay
AU - Blankenburg, Rebecca L.
AU - Kahana, Madelyn
AU - Spackman, Jaime Blank
AU - Stevenson, Adam
AU - Barton, Kevin
AU - Berchelmann, Kathleen
AU - Sessions Cole, F.
AU - Hrach, Christine
AU - Schultz, Kyle S.
AU - Turmelle, Michael P.
AU - White, Andrew J.
AU - Carlson, Bronwyn D.
N1 - Publisher Copyright:
© 2015 Society of Hospital Medicine.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - BACKGROUND: Handoffs of patient care are a leading root cause of medical errors. Standardized techniques exist to minimize miscommunications during verbal handoffs, but studies to guide standardization of printed handoff documents are lacking. OBJECTIVE: To determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents. SETTING: Pediatric hospitalist services at 9 institutions in the United States and Canada. METHODS: Sample handoff documents from each institution were reviewed, and structured group interviews were conducted to understand each institution's priorities for written handoffs. An expert panel reviewed all handoff documents and structured group-interview findings, and subsequently made consensus-based recommendations for data elements that were either essential or recommended, including best overall printed handoff practices. RESULTS: Nine sites completed structured group interviews and submitted data. We identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17%) were uniformly present in all sites' handoff documents. The expert panel recommended the following as essential for all printed handoffs: assessment of illness severity, patient summary, action items, situation awareness and contingency plans, allergies, medications, age, weight, date of admission, and patient and hospital service identifiers. Code status and several other elements were also recommended. CONCLUSIONS: Wide variation exists in the content of printed handoff documents. Standardizing printed handoff documents has the potential to decrease omissions of key data during patient care transitions, which may decrease the risk of downstream medical errors.
AB - BACKGROUND: Handoffs of patient care are a leading root cause of medical errors. Standardized techniques exist to minimize miscommunications during verbal handoffs, but studies to guide standardization of printed handoff documents are lacking. OBJECTIVE: To determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents. SETTING: Pediatric hospitalist services at 9 institutions in the United States and Canada. METHODS: Sample handoff documents from each institution were reviewed, and structured group interviews were conducted to understand each institution's priorities for written handoffs. An expert panel reviewed all handoff documents and structured group-interview findings, and subsequently made consensus-based recommendations for data elements that were either essential or recommended, including best overall printed handoff practices. RESULTS: Nine sites completed structured group interviews and submitted data. We identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17%) were uniformly present in all sites' handoff documents. The expert panel recommended the following as essential for all printed handoffs: assessment of illness severity, patient summary, action items, situation awareness and contingency plans, allergies, medications, age, weight, date of admission, and patient and hospital service identifiers. Code status and several other elements were also recommended. CONCLUSIONS: Wide variation exists in the content of printed handoff documents. Standardizing printed handoff documents has the potential to decrease omissions of key data during patient care transitions, which may decrease the risk of downstream medical errors.
UR - http://www.scopus.com/inward/record.url?scp=84938213585&partnerID=8YFLogxK
U2 - 10.1002/jhm.2380
DO - 10.1002/jhm.2380
M3 - Article
C2 - 26014471
AN - SCOPUS:84938213585
SN - 1553-5592
VL - 10
SP - 517
EP - 524
JO - Journal of hospital medicine
JF - Journal of hospital medicine
IS - 8
ER -