Developing an emergency medicine handoff tool: an electronic Delphi approach.

Area of Science:

• Emergency Medicine
• Healthcare Quality Improvement

Background:

• Clinical shift handoffs in emergency departments are frequent and carry significant patient risk.
• Standardization of handoff practices is needed to mitigate these risks.

Purpose of the Study:

• To identify core elements for emergency department physician-to-physician handoffs using an electronic Delphi method.
• To propose a framework for implementing standardized handoffs.

Main Methods:

• An electronic Delphi study involving a national panel of Saudi Arabian board-certified emergency physicians.
• Four rounds of consensus-building to identify, categorize, and rank essential handoff elements.

Main Results:

• Thirty-two critical handoff elements were identified and categorized into four domains.
• Top-ranked elements included patient identification, chief complaint, clinical stability, diagnosis, and consulting services.
• High inter-rater reliability (Cronbach's alpha 0.93) was achieved.

Conclusions:

• A ranked list of implementable elements for standardizing physician handoffs in emergency departments was developed.
• The methodology can be adapted for developing handoff frameworks in other medical disciplines and settings.