@article{12191,
  keywords = {care failure, handovers, patient safety, quality improvement, transition of care},
  author = {Michael T. Bigham and Tina R. Logsdon and Paul E. Manicone and Christopher P. Landrigan and Leslie W. Hayes and Kelly H. Randall and Purva Grover and Susan B. Collins and Dana E. Ramirez and Crystal D. O'Guin and Catherine I. Williams and Robin J. Warnick and Paul J. Sharek},
  title = {Decreasing handoff-related care failures in children's hospitals.},
  abstract = {<p><b>BACKGROUND AND OBJECTIVE: </b>Patient handoffs in health care require transfer of information, responsibility, and authority between providers. Suboptimal patient handoffs pose a serious safety risk. Studies demonstrating the impact of improved patient handoffs on care failures are lacking. The primary objective of this study was to evaluate the effect of a multihospital collaborative designed to decrease handoff-related care failures.</p><p><b>METHODS: </b>Twenty-three children's hospitals participated in a quality improvement collaborative aimed at reducing handoff-related care failures. The improvement was guided by evidence-based recommendations regarding handoff intent and content, standardized handoff tools/methods, and clear transition of responsibility. Hospitals tailored handoff elements to locally important handoff types. Handoff-related care failures were compared between baseline and 3 intervention periods. Secondary outcomes measured compliance to specific change package elements and balancing measure of staff satisfaction.</p><p><b>RESULTS: </b>Twenty-three children's hospitals evaluated 7864 handoffs over the 12-month study period. Handoff-related care failures decreased from baseline (25.8%) to the final intervention period (7.9%) (P < .05). Significant improvement was observed in every handoff type studied. Compliance to change package elements improved (achieving a common understanding about the patient from 86% to 96% [P < .05]; clear transition of responsibility from 92% to 96% [P < .05]; and minimized interruptions and distractions from 84% to 90% [P < .05]) as did overall satisfaction with the handoff (from 55% to 70% [P < .05]).</p><p><b>CONCLUSIONS: </b>Implementation of a standardized evidence-based handoff process across 23 children's hospitals resulted in a significant decrease in handoff-related care failures, observed over all handoff types. Compliance to critical components of the handoff process improved, as did provider satisfaction.</p>},
  year = {2014},
  journal = {Pediatrics},
  volume = {134},
  pages = {e572-e579},
  month = {08/2014},
  issn = {1098-4275},
  doi = {10.1542/peds.2013-1844},
  language = {eng},
}