Clinical Focus on Quality

When a patient's care is transferred from one provider to another, or from one patient care setting to another, this is called a "hand-off."

The context can vary from a nursing shift change for a stable patient to an inter-hospital transfer of a critically ill patient via helicopter; however, whenever a hand-off occurs, it is very important that the correct information be transmitted from one provider to the next in order to ensure proper care of the patient and to avoid preventable errors.

In August 2009, the Joint Commission Center for Transforming Healthcare invited a team from Intermountain Healthcare to join in a collaborative project with nine other leading healthcare systems to improve the quality of hand-off communications. Physician and nursing leaders at LDS Hospital volunteered to spearhead our involvement in this collaborative project, and project leader Brian Puska, director of Decision Support for Intermountain, reports that the team has made great progress in identifying barriers to effective communication and devising strategies for improvement. Examples of strategies include a well-defined checklist and minimization of interruptions during the hand-off process. Brian joins a biweekly conference call with the other collaborating institutions and reports that Intermountain is contributing in significant ways. The duration of the project has not been explicitly defined, but it is expected to continue at least until September.

At the conclusion of the project we hope to have improved tools and methods for hand-off communications in a variety of clinical settings, which should be of benefit to patients at all Intermountain Healthcare facilities and to patients at other institutions throughout the nation.

What you can do:

  • Ask leadership at your local hospital what is being done to improve hand-off communications.
  • Check out the Joint Commission's video on this project:.

Intermountain's associate chief medical officer, Doug Smith, MD, appears in the video.

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