Ineffective handoff communication presents a critical threat to patient safety. An estimated 80% of serious medical errors involve miscommunication during handoffs and transfers. These errors can lead to patient harm and increased costs. To help prevent such problems, The Joint Commission Center for Transforming Healthcare has released a new handoff communications tool.
The Targeted Solutions Tool™ (TST™) measures the effectiveness of handoffs conducted either from one department to another within the same facility or from one facility to another. More importantly, the tool provides proven solutions. During the Handoff Communications Project that developed the tool, organizations that used TST™ reaped many benefits. They reported:
- increased satisfaction for patients, families, and staff members
- a reduction of 52.3% in problematic handoffs
- reduced patient readmissions by up to 50%
- reduced time to move patients from the emergency department to the inpatient unit.
Interestingly, the organizations that used the TST™ had to make only minor changes in the roles and responsibilities of existing staff to gain the benefits that the tool offers.
Studying Handoff Problems
The Joint Commission Center for Transforming Healthcare was well aware of the problems that can result from ineffective handoffs, which include:
- delayed or inappropriate treatment
- adverse events
- omission of care
- increased length of hospital stay
- avoidable readmissions
- increased costs
- inefficiency from rework.
To develop the right tool to address these problems, the Center studied patient transfers in 10 hospitals. The study found that expectations related to handoffs differed significantly between senders (caregivers who transmit patient data and transfer care) and receivers (caregivers who accept patient data and care). By using the TST™, senders and receivers had better matched expectations, developed a successful handoff process, and had more effective communications and relationships. These organizations found that the TST™:
- aided in examining existing handoff communications from both the sender and receiver viewpoints.
- accurately measured data for improving the existing handoff communications.
- pinpointed areas for improvement, such as the need for different types of information in different handoff settings.
- provided customizable forms for data collection
- offered guidelines for determining the most appropriate, realistic handoff communication process for each type of transfer.
Solving Handoff Problems with SHARE
The Center and the 10 hospitals that participated in the study developed handoff communications solutions based on the acronym SHARE. Each letter in the acronym addresses a specific area that is key to a successful handoff. Here are the SHARE elements with a few examples:
S = Standardize critical content
- Give the receiver details of the patient’s history.
- Emphasize key patient data for the receiver.
- Synthesize patient data from different sources before sharing it.
H = Hardwire within your system
- Develop standardized forms, tools, and methods, such as checklists.
- Work in a quiet space that’s conducive to sharing patient information.
- State expectations about conducting a successful transfer.
- Identify technologies to help make handoffs successful.
A = Allow opportunities to ask questions
- Use critical thinking skills when discussing a patient.
- Share and receive information as an interdisciplinary team.
- Expect to get all key patient data from the sender.
- Exchange contact information in case questions arise later.
- Scrutinize data and question it, if needed.
R = Reinforce quality and measurement
- Demonstrate leadership’s commitment to successful handoffs.
- Hold staff members accountable for managing the patient’s care.
- Monitor compliance with standardized handoff tools and processes.
- Use data in a systematic approach to improvement.
E = Educate and coach
- Teach staff members what makes a successful handoff.
- Standardize training on performing handoffs.
- Give staff members real-time feedback and just-in-time training.
- Make successful handoffs a priority.
More information about enhancing transitions of patient care is available from The Joint Commission Center for Transforming Healthcare. The information and tools available can improve handoff communications and help minimize errors and costs while maximizing patient safety and satisfaction.