Are face-to-face handoffs really necessary?

This question was examined in a recent study of hospitalized patients:

OBJECTIVE

Examine the relationship between face-to-face handoffs and the rate of patient outcomes, including adverse events.

DESIGN

Retrospective cohort.

SETTING

A 1157-bed academic tertiary referral hospital.

PATIENTS

There were 805 adult patients admitted to general internal medicine services.

INTERVENTION

Retrospective comparison of clinical outcomes, including the rate of adverse events, of patients whose care was transitioned with and without face-to-face handoffs.

MEASUREMENTS

Rapid response team calls, code team calls, transfers to a higher level of care, death in hospital, 30-day readmission rate, length of stay, and adverse events (as identified using the Global Trigger Tool).

RESULTS

There was no significant difference with respect to the frequency of rapid response team calls, code team calls, transfers to a higher level of care, deaths in hospital, length of stay, 30-day readmission rate, or adverse events between patients whose care was transitioned with or without a face-to-face handoff.

From comments on this study in ACPHospitalist Weekly:

However, they speculated that the lack of effect with face-to-face handoffs could suggest that clinicians were more vigilant in gathering data when they didn't receive a face-to-face handoff, spending more time reviewing the medical record, speaking with the patients, and communicating with other clinicians.

The results suggest that, as long as key information is communicated by other means (such as electronic tools, email, or phone), a face-to-face handoff is "not vital to ensure a safe care transition," the authors wrote. Future investigations should look for other strategies or qualities that affect the safety of handoffs, they suggested.