In a hospital setup, handoffs are instances in which the responsibility of a patient is handed over from one personnel to another (Bayley, 2005). During this process, important information regarding the patient is swapped. To improve on handoff processes, patients’ facts should not to be omitted during the shift change. Often poor communication has been cited as the main cause of medical errors. As illustrated by the joint commission in 2004, 70 percent of all hospitals' sentiments result from the lack of appropriate communication techniques leading to transfer from one medical expert to another (Bayley, 2005). To improve on handoff processes between emergency departments and other hospital departments, hospital administration must implement processes that clearly and effectively define the transfer of responsibility from one hospital personnel to another. In this regard more focus needs to be centered on the communication aspect rather than on specific handoffs (Bayley, 2005).

In emergency departments various tools and techniques can help to improve the efficiency of the handoff techniques normally involved between the emergency department and other departments. Traditional approaches have been in use in the emergency departments for long (Bayley, 2005). With this approach nurses engage in handoff processes away from their patients compromising on their effectiveness. Similarly, traditional approaches have enabled previous nurses to exchange the patients’ information verbally with incoming nurses, a strategy considered ineffective. To improve on its effectiveness, the hospitals’ administrations should consider the use of appropriate modern tools such as SBAR, five-Ps, I pass the Baton, Mnemonics, templates and checklists to mitigate loss of information (Bayley, 2005). With appropriate approaches, these techniques will ensure accurate and timely transfer of information.

Handoff methods


Situation background assessment recommendation (SBAR) can play a crucial role in an emergency department’s handoff process due to the large number of turnouts and numerous detailed reports required for every patient (Garber & Slonim, 2010). With the help of PACU, handoff patients’ information can be extracted and sent to the receiving end, normally positioned in different departments. Thereafter, the sender calls the receiver for any inquiries. Similarly, it is possible to exchange patient’s information via the phone. Through this process nurses communicate with other medical experts besides their patients, and thus improve on their relationship (Garber & Slonim, 2010).

The five-Ps

The development of this process aimed at simplifying accountability among health personnel and patient information (Garber & Slonim, 2010). The first P represents the patient and thus captures the patient’s name, identifiers, age, sex and location. The second P represents the plan and comprises of the patients’ diagnosis, treatment plan and the next steps administered by the nurse (Garber & Slonim, 2010). The third P represents the purpose and exhibits a rational care plan for the patient. The fourth P concerns the patients’ problems. It facilitates the explanation of unusualness regarding patients (Garber & Slonim, 2010). The last P represents precautions that must be observed during the treatment process.

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Most departments prefer the use of audio tapes as a means of sharing crucial information in handoff processes (Garber & Slonim, 2010). Similarly, emergency departments can employ this method to provide fast and well-organized means of communication. Through this approach audiotapes will provide the outgoing healthcare personnel with a means to record a comprehensive assessment for the incoming personnel (Garber & Slonim, 2010). However, when used alone, audiotapes do not meet the joint commission national patient safety goals. In this regard, there is the need to use several other techniques during handoff processes.

Form and checklist

Forms and checklists have been used in emergency departments in the provision of quick and consistent information (Garber & Slonim, 2010). With improvements in technology, modern information technology systems can play an effective role in emergency departments. Normally, forms and checklists are attached to a patient’s records to facilitate easier access of the patient’s information by medics. With the use electronic medical records one should ensure that patients’ information is often passed, received and reviewed (Garber & Slonim, 2010). Since its approval in emergency departments, this method has improved patients' and nurses' satisfaction in various operational aspects. The approach allows nurses to prioritize care and improve on their accountability (Garber & Slonim, 2010). Similarly, with the adoption of this strategy patients have felt included, as they are reassured of the medics’ attention. To ensure the nurses’ effectiveness during uncomfortable situations, especially in the presence of family members, scripting is coupled in the process (Garber & Slonim, 2010).

I pass the Baton and SBAR

To standardize on the handoff process among the emergency and other hospital departments, a combination of I pass the Baton and SBAR methods is employed for effective communication (McDonough & Larson, 2007). With this combination, there is a considerably enhanced nurses' and physicians' communication. In this regard, nurses keep short, brief and up-to-date forms on their patients in SBAR format. All the forms excluded from medical records are copied and placed in the plastic baton for transportation along with the patient wherever he or she is referred by the hospital (McDonough & Larson, 2007). When the information is required, it is easily previewed. These forms should have the outgoing nurses’ contact numbers and all stakeholders involved should sign them (McDonough & Larson, 2007).


For effective emergency handoff processes, several tips should be considered. During the handoff process the individuals involved should ensure that they allocate an appropriate amount of time to each handoff session to avoid errors (McDonough & Larson, 2007). Similarly, emergency handoff processes should be conducted in such a manner to ensure that the patient’s attention is monitored appropriately. In addition, a two-way communication should be the most preferred method to use (McDonough & Larson, 2007).

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