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Patient handoffs

Vineet Arora, MD, MAPP
Jeanne Farnan, MD, MHPE
Section Editor
Andrew D Auerbach, MD, MPH
Deputy Editor
Judith A Melin, MA, MD, FACP


The increasing fragmentation of health care has the unintended consequence of more care transitions. Transitions of patient care between providers occur frequently and require providers to transmit critical clinical information. If information is omitted or misunderstood, there may be serious clinical consequences [1,2]. Several studies have shown that handoffs are often variable and represent a major gap in safe patient care [3-5].

In addition to care transitions into and out of the hospital (extra-hospital handoffs), hospital care itself has become increasingly fragmented due to the increase in number of resident handoffs secondary to duty hour regulations [6] and the adoption of the shift-work type systems utilized by hospitalists. In-hospital handoffs are common in hospitals and represent a vulnerable time during patient care. For example, hospitalized patients are often passed between doctors an average of 15 times during a single five-day hospitalization [7]. Poor handoffs lead to uncertainty during clinical decision-making, which then leads to potential harm (near misses) and inefficient work in both resident and hospitalist service changes [8].

This topic will discuss patient handoffs that occur in the hospital. Transitions of care focused on hospital discharge are discussed elsewhere. (See "Hospital discharge and readmission".)


The sender provides the information for the handoff and the receiver receives the information and then assumes care of the patient. Other terminology used to describe patient handoff include:

Shift change – This is the transfer of responsibility that occurs when one clinician ends and another one begins their shift.


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Literature review current through: Jan 2017. | This topic last updated: Wed Jun 08 00:00:00 GMT+00:00 2016.
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