Project Firstline
Environmental Services Health Care Facilities Teamwork and Communication IPC Facilitator Toolkit

Handoff

Use a handoff tool for optimal patient transitions of care.

Whenever a patient changes locations or caregivers, a handoff should take place in order to ensure a smooth transition of care. There are several tools and models out there that can help you make a successful handoff, but no matter which tool you use, there should be a concise yet thorough transfer of information with the opportunity to ask clarifying questions and confirm key details. Use a handoff tool to effectively transfer responsibility and accountability for a patient's care.

What is a Handoff?

See It In Action

 
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Keep this in mind....

When it comes to handoffs, consistency is key. Each organization should pick just one handoff tool to use throughout the facility and encourage everyone to implement it.

 
Question 1 of 2
Why might someone fail to confirm information or ask clarifying questions during a handoff?

Not enough time—handoffs usually happen during transition periods where everyone is rushing to the next thing.

This isn't the only reason, but you're on the right track! If the sender makes it clear with nonverbal cues that they’re in a hurry and don’t want to be held up with questions, this can discourage the receiver from clarifying or confirming important information.

The receiver doesn’t want to look stupid by asking questions that might seem obvious.

This isn't the only reason, but you're on the right track! It can be difficult to overcome this self-consciousness, but it’s better to feel a little embarrassed than to miss important information or get a detail wrong that could impact patient safety

The situation seems simple or routine, so the receiver doesn’t feel the need to clarify or confirm information.

This isn't the only reason, but you're on the right track! Even if the handoff feels pretty straightforward, it’s important to take the time to make sure the receiver has the tools they need to provide proper care to the patient.

The receiver doesn’t know that they have the authority to ask for clarification rather than taking what they’re given without question.

This isn't the only reason, but you're on the right track! Even if you feel intimidated, understand that it’s part of your job to make sure that all information is communicated, clarified and confirmed as necessary during a handoff.

All of the above.

That's right! Limited time, self-consciousness, carelessness and feeling intimidated are all reasons someone might not confirm or clarify information during a handoff.

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Question 2 of 2
You're about to perform a patient handoff with someone who is already familiar with the patient and has overseen their care before.

How do you approach the handoff?

Skip it—they should know what to do.

Try again! Without a handoff tool, the other person won't have the crucial information they need to give the patient the best care possible. Even if the person you're handing the patient off to has heard it all before, a refresher certainly doesn't hurt.

Perform an abbreviated handoff with information that could be important or is new from last time.

Almost. You never know what information the other person might have forgotten. It may feel repetitive, but using the handoff tool in its entirety is the best way to ensure the other person has all the information they need to care for the patient.

Go through the entire handoff tool from beginning to end, even if you're repeating things they already know.

That's right! You never know what information the other person might have forgotten. It may feel repetitive, but the best way to ensure the other person has all the information they need to care for the patient is to use the handoff tool in its entirety.

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Put It Into Practice
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Help Sam and Zoe with a patient handoff.

What do you think Sam did wrong with this handoff?

He didn't give Zoe a chance to ask questions or clarify details.

Almost! It's true that Sam took off before Zoe could ask any questions or clarify details. But that's not the only thing wrong with Sam's handoff.

He didn't properly use a handoff tool, such as I-PASS.

You're almost there! It isn't clear what handoff tool Sam is trying to use here—it seems a bit all over the place. Without that structure, Zoe's going to have a hard time keeping track of the patient's information. But this isn't the only thing wrong with Sam's handoff.

He left out important patient information, such as allergies and current pain meds.

Close! This is important information to cover in a handoff, and if there's a miscommunication about medication, things could end badly for the patient. But this isn't the only thing wrong with Sam's handoff.

All of the above.

That's right! Sam didn't use the structure of a handoff tool, so he didn't give Zoe the patient's information in a structured way. He also left out key elements that could be crucial to the patient's care, and he took off before Zoe could ask any questions or clarify details. All of these mistakes could lead to a miscommunication that could negatively impact the patient's care.

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What could Zoe have done to get the information she needs?

She could have repeated back the information to Sam.

Almost! While it's always good to repeat back information, Sam provided a confusing, unstructured handoff.

She could have asked clarifying questions.

Good answer! If she has any questions about the patient's care, she would need to ask Sam before he leaves. She should also encourage Sam to use their agreed-upon handoff tool next time.

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Handoff Tools

Click through to read about some of the handoff tools available for you to choose from. Each is slightly different with unique advantages, so choose the tool that's best for your team.

 
 

I-PASS the BATON

This handoff tool from the TeamSTEPPS curriculum includes additional background about the patient, actions, timing, ownership of care and next steps.

Learn more about I-PASS the BATON.

 
 

I-PASS

Stands for: Illness severity (“stable,” “watcher,” or “unstable”); Patient Summary; Action list for the new team; Situation awareness and contingency plans; and Synthesis and "read back" of the information.

This tool has been shown to be particularly effective for physician signout communication and nursing handoffs.

Learn more about the I-PASS tool.

 
 

ANTICipate

Stands for: Administrative Data; New clinical information; Tasks to be performed; Illness severity; and Contingency plans for changes.

This handoff tool verifies administrative information, tasks to perform during care and “if-then” contingency plans.

Learn more about ANTICipate.

 
 

SHARQ

Stands for: Situation; History; Assessment; Recommendations/Result; and Questions.

Similar to SBAR, SHARQ covers the patient’s situation and history, the sender’s assessment and recommendations and an opportunity for questions at the end.

Learn more about SHARQ.

 
 

HAND-IT

The Handoff Intervention Tool follows a checklist-inspired, body system-oriented format to gather and organize information in preparation for a verbal handoff.

Learn more about the HAND-IT tool.

 

When you pick a tool to use for patient handoffs, let these principles be your guide.

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