25вЂ“27 Some nursing units may вЂњtransfer or discharge 40 percent to 70 percent of their patients every dayвЂќ 28 (p. 4, 7 Clinical environments are dynamic and complex, presenting many challenges for effective communication among health care providers, patients, and families. 11 Ineffective handoffs can contribute to gaps in patient care and breaches (i.e., failures) in patient safety, including medication errors, 19, 24 wrong-site surgery, 9 and patient deaths. Why Is There a Problem With Handoffs Today?ДЄs health care has evolved and become more specialized, with greater numbers of clinicians involved in patient care, patients are likely to encounter more handoffs than in the simpler and less complex health care delivery system of a few generations ago. The complexity and nuance of the type of information, communication methods, and various caregivers for each of these factors impact the effectiveness and efficiency of the handoff as well as patient safety. So, conceptually, the handoff must provide critical information about the patient, include communication methods between sender and receiver, transfer responsibility for care, and be performed within complex organizational systems and cultures that impact patient safety.

The handoff is also вЂњa mechanism for transferring information, primary responsibility, and authority from one or a set of caregivers, to oncoming staffвЂќ 17 (p. The concept of a handoff is complex and вЂњincludes communication between the change of shift, communication between care providers about patient care, handoff, records, and information tools to assist in communication between care providers about patient careвЂќ 1 (p. 20вЂ“22 For the purpose of this discussion, the term вЂњhandoffвЂќ will be used and defined as, вЂњThe transfer of information (along with authority and responsibility) during transitions in care across the continuum to include an opportunity to ask questions, clarify and confirmвЂќ 23 (p. There are a number of terms used to describe the handoff process, such as handover, 1, 13, 14 sign-out, 15, 16 signover, 17 cross-coverage, 18, 19 and shift report. First one needs to recognize the term вЂњhandoffвЂќ and synonymous terms that are used in a wide variety of contexts and clinical settings.

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