Problems with handoffs are a big deal in clinical practice. Defective handoffs lead to patient harm, treatment delays, inappropriate treatment, and longer stays in the hospital. In a typical patient handoff between physicians, important patient information is often not given to physicians who take over care of a patient. In a hospital, “[s]hift changes, also known as handoffs, are prime opportunities for key information about a patient’s condition to get lost in the shuffle,” according to a recently released study about patient handoffs in JAMA Internal Medicine .
In addition to hospital situations, patients get lost in the shuffle when they are handed off by their primary care physicians (PCPs) to specialists via a referral. “The classic fumble in the patient handoff is when the specialist thinks the primary care doctor is going to take care of some aspect of follow-up, and the primary care doctor thinks the specialist is handling it,” according to Medscape. It’s not always the case that PCPs and specialists communicate effectively.
Handoffs are some of the most prominent contributing factors towards breakdowns in the diagnostic process. A report from the Joint Commission’s Center for Transforming Healthcare estimated that 80% of serious medical errors involve miscommunication during patient transfers. 30% of missed or delayed diagnoses, including cancer diagnoses, are due to communications factors such as handoffs and failure to establish clear lines of responsibility. Addtionally, poorly-managed handoffs contribute to 20% of diagnostic errors that lead to malpractice suits .
“The handoff is a time that is particularly risky for patients if the care team is not adequately informed...and measures to improve communication during such periods have significantly reduced preventable errors.”
Improving handoffs reduces errors and saves lives
In the JAMA Internal Medicine article, a hospital used a custom computer code in an electronic health records (EHR) system to keep physicians up to date with important information when one shift of physicians transitioned to another. Some large health systems are building customized software like this for themselves, but there is a need for tools that are more widely available.
For handoffs that involve PCP referrals to specialists, a tool exists to prevent patients from getting lost in the care transition shuffle: an electronic referral management system that connects PCPs and specialist referral partners. Referral management software bridges the information gap that is created during patient handoffs, especially when PCPs and specialists are utilizing many different EHR systems. In the football game of electronic referral management, the classic fumble where physicians don’t communicate becomes a thing of the past. When handoffs are managed properly, practices get touchdowns in care coordination for all of their patients.
 JAMA Internal Medicine | http://archinte.jamanetwork.com/article.aspx?articleid=2540534
 Annals of Internal Medicine | http://www.ncbi.nlm.nih.gov/pubmed/17015866