Hands-off communication occurs when a patient is being transferred from one caregiver to another. Communication problems are the primary cause of sentinel events, and hands-off communication is a common cause of error. It’s not unusual for patients to be cared for by many different units during a hospital stay: presurgical unit, surgery, recovery room, critical care, medical-surgical

department, and so forth. Additionally, hands-off communication occurs at the change of every shift and when patients transfer to other facilities. Guidelines require that hands-off communications must include interactive questions and answers. Taped end-of-shift reports are not acceptable unless they include an interactive question and answer period after the oncoming staff person listens to the tape. Leaving a telephone number so that the person can call to ask questions is NOT sufficient.

Since this policy applies to physicians who are handing-off care of a patient, there must be some type of standardize procedure in place for physicians as well as other staff. Simply writing in a chart that another physician is taking over care of a patient is not considered adequate, as there must be interaction that allows for questions and answers. The Joint Commission recommends a number of strategies to improve communication and ensure that valuable information is communicated.

Improving hands-off communication

Use clear language. Avoid abbreviations, jargon, and generalizations, such as “She’s doing ngwell”. Giveor“Hs information: “His blood pressur saturation to 84%.”

Use effective communication techniques. Limit interruptions and allow time for questioning and feedback to ensure communication is effective.

Standardize shift-change and unit-change/reporting. Devise a standard method of hands-off reporting that is followed by all staff members. It may include a summary of history, orders, problems, laboratory tests, and other information, depending upon the type of facility.

Plan for smooth discharge to other facilities by beginning the process at admission and using a standardized approach that includes adequate documentation, a current list of medications and treatment, and any follow-up information, such as appointments.

Utilize technology, such as electronic medical records that can be accessed by all units or departments as needed