Improving Handoffs in the Emergency Department

Dickson S. Cheung, John J. Kelly, Christopher Beach, Ross P. Berkeley, Robert A. Bitterman, Robert I. Broida, William C. Dalsey, Heather L. Farley, Drew C. Fuller, David J. Garvey, Kevin M. Klauer, Lynne B. McCullough, Emily S. Patterson, Julius C. Pham, Michael P. Phelan, Jesse M. Pines, Stephen M. Schenkel, Anne Tomolo, Thomas W. Turbiak, John A. VozenilekRobert L. Wears, Marjorie L. White

Research output: Contribution to journalArticlepeer-review

155 Scopus citations


Patient handoffs at shift change are a ubiquitous and potentially hazardous process in emergency care. As crowding and lengthy evaluations become the standard for an increasing proportion of emergency departments (EDs), the number of patients handed off will likely increase. It is critical now more than ever before to ensure that handoffs supply valid and useful shared understandings between providers at transitions of care. The purpose of this article is to provide the most up-to-date evidence and collective thinking about the process and safety of handoffs between physicians in the ED. It offers perspectives from other disciplines, provides a conceptual framework for handoffs, and categorizes models of existing practices. Legal and risk management issues are also addressed. A proposal for the development of handoff quality measures is outlined. Practical strategies are suggested to improve ED handoffs. Finally, a research agenda is proposed to provide a roadmap to future work that may increase knowledge in this area.

Original languageEnglish (US)
Pages (from-to)171-180
Number of pages10
JournalAnnals of emergency medicine
Issue number2
StatePublished - Feb 2010
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine


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