Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background: Delays in the discharge process of hospitalized patients impact patient flow and lead to increased costs and slower progression of care. As hospitalist work becomes increasingly shift based, there are concerns for proper patient handoffs and hesitancy with clinical progression of care overnight. This leads to daytime patient flow congestion and is a significant [...]

Background: Approximately 1.6 million patients are transferred between hospitals yearly, with disproportionately high cost and mortality. Despite the risk associated with inter-hospital transition of care, there is no established best practice in coordinating and triaging transfers. This gap in knowledge is partly driven by a dearth of studies which integrate clinical data before and after [...]

Background: Despite the current focus on developing handoff training curricula to improve patient safety, rigorous assessments of handoffs remain scarce. Immersive simulations allow for the evaluation of communication skills, but few specifically account for common external threats to effective handoff performance. Our aim was to investigate the effects of these interruptions in an educational handoff [...]

Background: National guidelines recommend hospitals implement standardized approaches to handoffs, and recent quantitative research has indicated that standardized approaches such as the I-PASS tool can lead to sustained improvements in patient safety and provider communication in a diverse array of settings.1 Our hospital medicine group piloted a formal written handoffs process based on the I-PASS [...]

Background: Communication has been cited as the most common root cause in sentinel events, with failed patient care handoffs contributing to an estimated 80% of serious preventable adverse events. Handoffs to sub-acute care such as nursing homes are at particularly high risk for communication breakdown given high patient complexity and comorbidity. Our healthcare system includes [...]

Background: Hospitalized medical patients transitioning to new house staff at the end of an inpatient resident rotation are associated with an increased risk of mortality as compared with patients not exposed to such handoffs, yet no data exist on improvement strategies targeting this transition. Given the frequency with which residents rotate service, a transition in [...]

Background: Direct admissions (DA), wherein patients are non-emergently admitted to the hospital, bypassing the emergency room (ER), makeup 15% of non-elective adult hospitalizations (1). DAs can reduce ER volumes (2), but may lead to delays in initial evaluation of patients and inappropriate admissions (2,3). DAs carry risks involved with transitions of care and handoffs, yet [...]

Background: Communication breakdown plays a part in the majority of adverse events in healthcare. Physician to physician handoffs are particularly prone to communication errors, yet have been shown to be more complete when systematized according to a standardized bundle. However,  the degree to which individual elements of this bundle, including written versus verbal handoffs, contribute [...]

Background: Handoffs are critical to safe and efficient transfer of patient care between hospitalists. While patient handoffs are essential to hospitalist practice, there is great variability in handoff content, preparation, and delivery. Our study aimed to characterize handoff practices at a large academic hospitalist group, which primarily utilizes a written handoff platform. Methods: We conducted [...]