What’s the secret to smooth patient handoffs during shift changes?

Properly transitioning patient cases during shift change is critical for safety and continuity of care. In fact, handoffs are often considered one of the most vulnerable moments in a patient’s journey, where miscommunication can lead to errors. But when every provider has their own style and way of retaining information, the challenge is making sure care remains consistent. 

On Healthcasts, clinicians across specialties are sharing their best practices for patient handoff to improve this process. From standardized frameworks to written summaries and team involvement, these strategies help ensure nothing falls through the cracks.

How do you communicate case details when handing a patient off to a colleague? Log in or sign up to read the full post and see the Consensus. 

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Key takeaways about best practices for patient handoffs:   

• Use structured frameworks for consistency
  Standardized tools like SBAR or I-PASS help organize critical details, such as current issues, pending tests, and contingency plans, into a clear, repeatable format that helps to minimize errors.
  
• Combine written and verbal communication for clarity
  Pairing EMR notes or written summaries with verbal exchanges creates a safety net for patient information. Adding closed-loop communication by asking the receiver to repeat back key points further ensures accuracy.
  
• Foster collaboration across the care team
  Smooth handoffs require teamwork. Involving nursing staff, using sign-out conferences, and confirming understanding with colleagues helps keep everyone aligned. 
  

Pediatrics

"I think it is important to have a written summary of key points on each patient, so that nothing is forgotten/ missed. Then, I go through that list with the incoming provider. It is also good to involve the nursing staff, so that they can ensure the same."

Hospitalist

"Written handoffs are directly written with EHR context. Follow-up text for any questions midday the following day."

Internal Medicine

"When I hand off a patient, I use a structured approach like SBAR or I-PASS to make sure nothing gets missed. I focus on the patient’s current problems, recent changes, pending tests, and any urgent issues, and I make sure the person receiving the handoff understands by having them repeat back key points. I also include what to watch for and next steps if things change. Whenever possible, I do the handoff face-to-face and supplement it with written or EMR notes so everything is clear and nothing falls through the cracks."

Internal Medicine

"EPIC has a handoff or summary tab that can be used. I like to place a detailed note outlining the plan for assessment and plan so nothing falls through the cracks. Also, in the case of a sick patient or something sensitive, a phone call to the physician taking over is the best way to go."

Surgeon

"Handoffs are the most dangerous moments in a patient's stay, as that's where we often lose the thread of the clinical story. To keep things bulletproof, I rely on I-PASS, which forces us to move past a quick verbal dump by structuring the summary, identifying specific action items, and—crucially—contingency planning ('If X happens, do Y').

I ensure we use closed-loop communication where the incoming surgeon repeats the plan back to me; if they can't echo the "if/then" scenarios, the handoff isn't done. By standardizing this within synoptic handoff templates in the EMR, we turn a sloppy chat into a structured log that protects both the patient and the team."

Family Practice

"Make sure the person you are giving to report to is concentrating, focusing just on you. Avoid loud areas and make sure they are writing down details that can not be memorized."

Oncology/Hematology

"Written and verbal communication during handoffs. Although they almost never do, my colleagues know that they can call me as well if any questions come up or if clarification is needed. Again, this is exceedingly rare that they do this, but they know it's an option if needed."

Neurology

"We have a 1-hour sign-out conference in which we discuss patients, history, workup, treatments, etc."

Ophthalmology/Optometrist

"Making sure clinicians understand the case and patient, as well as that they are being handed off. Also, notes need to be easily understood. I try to talk with a colleague prior to handing the patient off to let them know what’s going on with the case."

Oncology/Hematology

"At the end of the conversation, I always add, 'Do you need any additional information that wasn't delivered on (difficult case)?'"

Your expertise can help shape best practices for smoother, more efficient patient handoffs. Share the strategies you use when transitioning patients over to colleagues, and read all of the comments on the post on Healthcasts.