Table 4 Use of strategies from high-reliability organisations
Strategies used consistently/frequentlyStrategic used occasionallyStrategies never used“Strategies” residents considered goals for the hand-off
Face-to-face verbal update with interactive questions and answersAdditional update from practitioners other than the one being replaced (ICU, postanaesthesia care unit)Limit interruptions during updateInclude the outgoing team’s stance toward changes to plans and contingency plans
Topics initiated by incoming as well as outgoingIncoming scans historical data before the updateRead back to ensure that information is accurately receivedProvide the incoming consistently with the most up-to-date information
Limit initiation of actions during update (except for emergencies)Incoming reviews changes to sensor-derived data before the update (ICU only)Intermittent monitoring of system status while “on call” (prior to the hand-off)Ensure an unambiguous transfer of responsibility
Outgoing writes summary before handoffOutgoing has knowledge of previous shift activitiesOutgoing oversees incoming’s work following the updateMake it transparent who is responsible to others involved in the care of the patient
Incoming assesses current statusIncoming receives paperwork including annotations (used when verbal hand-offs are omitted)
Information updated in a consistent order every timeStaff members overhear others' updates
Delay transfer when concerned about status/stability of process (for major problems)
  • Strategies first reported by Patterson et al.1