Handoff tool alone insufficient to handle nighttime clinical issues

(HealthDay)—A handoff tool, which has been widely adopted in hospitals, seems not to be sufficient for addressing nighttime clinical issues, according to research published in the March issue of the Journal of Hospital Medicine.

Joshua T. Hanson, M.D., M.P.H., from the South Texas Veterans Health Care System in San Antonio, and colleagues conducted real-time data collection to examine what clinical work is done overnight, housestaff perception of overnight clinical work, and how handoff instruments support this work. Complete data were available for 289 nighttime clinical encounters. Residents' perceptions toward care transitions were assessed via survey.

The researchers found that in 27.7 percent of encounters the handoff tool was used as an information source, while the nurse or the chart were used as the information source in 94.4 percent of encounters. A new order for a medication resulted for many encounters, while 3.8 percent of encounters resulted in documentation. According to the survey data, most residents (73.6 percent) reported that the sign-out procedure was safe.

"These data suggest that a handoff tool is not sufficient to address nighttime clinical issues and suggest that effective care requires more than just the information transfer," the authors write.

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