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PATIENT SAFETY PRIMERS
Handoffs and Signouts

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•Device-related Complications (2)

•Diagnostic Errors (7)

•Identification Errors (1)

•Discontinuities, Gaps, and Hand-Off Problems (135)

•Fatigue and Sleep Deprivation (2)

•Medication Safety (14)

•Medical Complications (3)

•Nonsurgical Procedural Complications (1)

•Surgical Complications (21)

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•Special or Theme Issue (2)

•Tools/Toolkit (4)

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•Epidemiology of Errors and Adverse Events (32)

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Approach to Improving Safety
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Structured Hand-offs

Clinical Areas

•Medicine (126)

•Nursing (19)

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Target Audience

•Health Care Providers (124)

•Health Care Executives and Administrators (123)

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Setting of Care

•Hospitals (128)

•Residential Facilities (2)

•Ambulatory Care (10)

•Outpatient Surgery (1)

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1 - 20 of 147

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REVIEW

Can we make postoperative patient handovers safer? A systematic review of the literature.

Segall N, Bonifacio AS, Schroeder RA, et al; Durham VA Patient Safety Center of Inquiry. Anesth Analg. 2012;115:102-115.

STUDY

Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.

Boat AC, Spaeth JP. Paediatr Anaesth. 2013 May 18; [Epub ahead of print].

STUDY

Burns surgery handover study: trainees' assessment of current practice in the British Isles.

Al-Benna S, Al-Ajam Y, Alzoubaidi D. Burns. 2009;35:509-512.

STUDY

An evaluation of information transfer through the continuum of surgical care: a feasibility study.

Nagpal K, Vats A, Ahmed K, Vincent C, Moorthy K. Ann Surg. 2010;252:402-407.

STUDY

Pilot implementation of a perioperative protocol to guide operating room-to-intensive care unit patient handoffs.

Petrovic MA, Aboumatar H, Baumgartner WA, et al. J Cardiothorac Vasc Anesth. 2012;26:11-16.

STUDY

classic

Postoperative handover: problems, pitfalls, and prevention of error.

Nagpal K, Arora S, Abboudi M, et al. Ann Surg. 2010;252:171-176.

STUDY

Surgical case listing accuracy: failure analysis at a high-volume academic medical center.

Cima RR, Hale C, Kollengode A, Rogers JC, Cassivi SD, Deschamps C. Arch Surg. 2010;145:641-646.

STUDY

Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality.

Catchpole KR, de Leval MR, McEwan A, et al. Paediatr Anaesth. 2007;17:470-478.

STUDY

Multitasking during patient handover in the recovery room.

van Rensen EL, Groen ES, Numan SC, et al. Anesth Analg. 2012;115:1183-1187.

STUDY

The effect of a checklist on the quality of post-anaesthesia patient handover: a randomized controlled trial.

Salzwedel C, Bartz HJ, Kühnelt I, Appel D, Haupt O, Maisch S, Schmidt GN. Int J Qual Health Care. 2013;25:176-181.

STUDY

Errors in administration of parenteral drugs in intensive care units: multinational prospective study.

Valentin A, Capuzzo M, Guidet B, et al; Research Group on Quality Improvement of the European Society of Intensive Care Medicine (ESICM); Sentinel Events Evaluation (SEE) Study Investigators. BMJ. 2009;338:b814.

COMMENTARY

The top 10 list for a safe and effective sign-out.

Kemp CD, Bath JM, Berger J, et al. Arch Surg. 2008;143:1008-1010.

NEWSPAPER/MAGAZINE ARTICLE

A hospital races to learn lessons of Ferrari pit stop.

Naik G. Wall Street Journal. November 14, 2006:A1. [reprinted on Post-gazette.com].

REVIEW

Information transfer and communication in surgery: a systematic review.

Nagpal K, Vats A, Lamb B, et al. Ann Surg. 2010;252:225-239.

STUDY

Handing over patient care: is it just the old broken telephone game?

Zendejas B, Ali SM, Huebner M, Farley DR. J Surg Educ. 2011;68:465-471.

STUDY

Handover after pediatric heart surgery: a simple tool improves information exchange.

Zavalkoff SR, Razack SI, Lavoie J, Dancea AB. Pediatr Crit Care Med. 2011;12:309-313.

STUDY

Standardized postoperative handover process improves outcomes in the intensive care unit: a model for operational sustainability and improved team performance.

Agarwal HS, Saville BR, Slayton JM, et al. Crit Care Med. 2012;40:2109-2115.

COMMENTARY

Fumbled Handoff.

Vidyarthi A. AHRQ WebM&M [serial online]. March 2004.

REVIEW

Addressing postdischarge adverse events: a neglected area.

Tsilimingras D, Bates DW. Jt Comm J Qual Patient Saf. 2008;34:85-97.

STUDY

Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results.

Telem DA, Buch KE, Ellis S, Coakley B, Divino CM. Arch Surg. 2011;146:89-93.

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