Improving handoffs in the emergency department

Area of Science:

• Emergency Medicine
• Healthcare Quality and Safety
• Medical Handoffs

Background:

• Patient handoffs during shift changes are common and carry risks in emergency care.
• Increasing emergency department (ED) crowding and evaluation times exacerbate handoff challenges.
• Effective handoffs are vital for ensuring shared understanding between providers during care transitions.

Purpose of the Study:

• To present current evidence and expert consensus on the process and safety of physician handoffs in the ED.
• To explore interdisciplinary perspectives, conceptual frameworks, and existing handoff models.
• To address legal/risk management aspects and propose quality measures for ED handoffs.

Main Methods:

• Comprehensive literature review of evidence on emergency department physician handoffs.
• Synthesis of collective thinking and perspectives from various disciplines.
• Categorization of existing handoff practices and models.

Main Results:

• Identified critical need for improved handoff processes in busy EDs.
• Outlined a conceptual framework and categorized current handoff practices.
• Proposed strategies for enhancing handoff quality and safety, including quality measures and a research agenda.

Conclusions:

• Optimizing ED physician handoffs is essential for patient safety and effective care continuity.
• A multi-faceted approach, incorporating evidence, interdisciplinary insights, and quality metrics, is necessary.
• Further research is needed to advance knowledge and develop best practices for handoffs.