Association of face-to-face handoffs and outcomes of hospitalized internal medicine patients.

Abstract

BACKGROUND: Failures in communication at the time of patient handoff have been implicated as contributing factors to preventable adverse events. OBJECTIVE: Examine the relationship between face-to-face handoffs and the rate of patient outcomes, including adverse events. DESIGN: Retrospective cohort. SETTING: A 1157-bed academic tertiary referral hospital. PATIENTS: There were 805 adult patients admitted to general internal medicine services. INTERVENTION: Retrospective comparison of clinical outcomes, including the rate of adverse events, of patients whose care was transitioned with and without face-to-face handoffs. MEASUREMENTS: Rapid response team calls, code team calls, transfers to a higher level of care, death in hospital, 30-day readmission rate, length of stay, and adverse events (as identified using the Global Trigger Tool). RESULTS: There was no significant difference with respect to the frequency of rapid response team calls, code team calls, transfers to a higher level of care, deaths in hospital, length of stay, 30-day readmission rate, or adverse events between patients whose care was transitioned with or without a face-to-face handoff. CONCLUSIONS: Face-to-face handoff of patients admitted to general medical services at a large academic tertiary referral hospital was not associated with a significant difference in measured patient outcomes, including the rate of adverse events, compared to a non-face-to-face handoff. Additional study is needed to determine the qualities of patient handoff that optimize efficiency and safety.