The Published Literature on Handoffs in Hospitals

Deficiencies Identified in an Extensive Review

A review of existing research on handoffs in order to inform the improvement and standardization of the handoff process in hospitals found that in existing literature, key concepts remain poorly defined and that patient safety is not analyzed against handoffs’ other functions.

Handoffs In hospitals occur when responsibility for and information about a patient changes from one health professional to another, and they may result in increased patient risk. The authors collected and reviewed all published research in English on medical personnel handoffs through July 2008.

Review of the literature revealed that “handoff” and “standardization” are poorly defined, resulting in ambiguities in what activities or documents “handoff” actually entails, and what practice modifications the standardization of handoffs would require. The literature also showed that handoffs have functions beyond patient safety, such as training and supporting medical personnel, but did not weigh the benefits of those other functions against patient safety. In general, studies failed to establish whether attempts to standardize handoffs have improved patient outcomes.

Existing research on handoffs does not support research conclusions on best practices in, nor the need for, the standardization of handoffs. Implementing widespread changes would therefore be difficult. The literature can, however, offer insights into ways to continue working to improve handoffs.

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