Improving Handoffs in the Emergency Department - 20/08/11
, John J. Kelly, DO, Christopher Beach, MD, Ross P. Berkeley, MD, Robert A. Bitterman, MD, JD, Robert I. Broida, MD, William C. Dalsey, MD, MBA, Heather L. Farley, MD, Drew C. Fuller, MD, MPH, David J. Garvey, PhD, MD, Kevin M. Klauer, DO, Lynne B. McCullough, MD, Emily S. Patterson, PhD, Julius C. Pham, MD, PhD, Michael P. Phelan, MD, JD, Jesse M. Pines, MD, MBA, MSCE, Stephen M. Schenkel, MD, MPP, Anne Tomolo, MD, MPH, Thomas W. Turbiak, MD, John A. Vozenilek, MD, Robert L. Wears, MD, MS, Marjorie L. White, MD 
American College of Emergency Physicians Section of Quality Improvement and Patient Safety
Address for correspondence: Dickson S. Cheung, MD, MBA, MPH, Carepoint, P.C., 5600 South Quebec Street, Suite 312A, Greenwood Village, CO 80111; 303-956-7381, fax 303-649-9973Résumé |
Patient handoffs at shift change are a ubiquitous and potentially hazardous process in emergency care. As crowding and lengthy evaluations become the standard for an increasing proportion of emergency departments (EDs), the number of patients handed off will likely increase. It is critical now more than ever before to ensure that handoffs supply valid and useful shared understandings between providers at transitions of care. The purpose of this article is to provide the most up-to-date evidence and collective thinking about the process and safety of handoffs between physicians in the ED. It offers perspectives from other disciplines, provides a conceptual framework for handoffs, and categorizes models of existing practices. Legal and risk management issues are also addressed. A proposal for the development of handoff quality measures is outlined. Practical strategies are suggested to improve ED handoffs. Finally, a research agenda is proposed to provide a roadmap to future work that may increase knowledge in this area.
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| Supervising editor: Donald M. Yealy, MD |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Funding for this project was provided by an American College of Emergency Physicians Section Grant to the Quality Improvement and Patient Safety section. Portions of the manuscript were created as products of grant number 1 U18 HS016640 from the Agency for Healthcare Research and Quality. |
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| Publication date: Available online October 2, 2009. |
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| Earn CME Credit: Continuing Medical Education is available for this article at: www.ACEP-EMedhome.com. |
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| Reprints not available from the authors. |
Vol 55 - N° 2
P. 171-180 - février 2010 Retour au numéro
Article précédent
- Exploring Emergency Physician–Hospitalist Handoff Interactions: Development of the Handoff Communication Assessment
- Julie Apker, Larry A. Mallak, E. Brooks Applegate, Scott C. Gibson, Jason J. Ham, Neil A. Johnson, Richard L. Street
- Communication, Communication, Communication: The Art of the Handoff
- Scott C. Gibson, Jason J. Ham, Julie Apker, Larry A. Mallak, Neil A. Johnson
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