10 Ways to Improve Handoffs in Your Hospital

6. Review every patient. Residents should review every patient during the handoff, Arora says. The giver should verbally identify each patient and state all of the anticipated problems that may arise. Next, he or she should list the major medical issues and the to-do list the cross-cover practitioner needs to complete. The receiver should be an active listener, take notes, and read all of the items on the to-do list back to ensure that he or she understood everything.

7. Identify sick patients upfront. If the patient is sick or the team is particularly concerned, the giver should say that at the beginning of the patient's handoff, says Airan-Javia. This helps to ensure that the physician receiving the information understands the seriousness of the situation and asks the appropriate questions.

8. Explain the rationale. It's a common mistake for information givers to assume that receivers know everything that they know about the patient. Residents handing off patients to another physician should explain their rationale for each order.

"We encourage people to be as specific as possible and use concrete language," Arora says.

For example, it's common to note "check basic metabolic profile" in the handoff documentation. However, the resident should specify that he or she is concerned about the patient's potassium levels, not sodium levels.

9. Avoid nonstandard abbreviations. Many abbreviations have different meanings depending on who is reading them, Kogan says. For example, a medicine resident may abbreviate hyperlipidemia as "HL." If an oncology consult is called, the oncologist may interpret that as Hodgkin's lymphoma, which can create a lot of confusion, Kogan says.

10. Use if-then scenarios. Focusing the discussion on contingencies (e.g., if patient reacts this way, do X; if patient reacts that way, do Y) gives receiving physicians a clear understanding of what they should consider doing during their shifts.

Julie McCoy is an associate editor for the residency department at HCPro. For more residency news, please visit www.residencymanager.com.