Handoffs are the glue that holds together a patient's care in the hospital. Yet traditionally they have been a disorganized—even sloppy—process. During my residency, we used paper and pencil to keep track of patients and transfer their care to others. We kept these pieces of paper folded in our pockets and constantly updated them by erasing and rewriting on them. Over the course of a day and a night on call, that pristine piece of paper got tattered and torn, confused with scribbles, eraser marks and shorthand made by many doctors. Somewhere on that paper was the right information, but it wasn't always easy to find. At Kaiser Permanente, where I practice, Doug Bonacum, vice president of Safety Management, is tasked with making handoffs work. He's not a doctor himself—he's a nuclear engineer and former Navy submariner. He is trying to show that the techniques he learned in the military to communicate are the exact same ones doctors need to use during handoffs.
