Please Don't Drop Me

Like everything, there is a right way and a wrong way to create a great patient and doctor experience. One way to create a terrible patient experience is to drop them in the handoff.

There are plenty of challenges and opportunities when it comes to improving the patient experience. We are also paying more attention to the doctor experience, since one follows the other. Like everything, there is a right way and a wrong way to create a great patient and doctor experience. One way to create a terrible patient experience is to drop them in the handoff.

Every patient should expect to not be fumbled, yet is happens over half the time and accounts for 70-80% of medical errors. So what's the problem. Why is it so hard to get this right?

1. Handoffs, whether it's intramural or extramural, involve several components that are just waiting to sabotage the best intentions.

2. Those factors are the sender, the receiver, third-party intermediaries, the patient and, the worse of them all, the system.

3. There are recommendations galore on how to minimize handoff errors, but they tend to be focused on specific senders (nurse to nurse after a shift change or ICU to floor) and don't address the unique pain points of the various stakeholders.

4. We don't have a standardized handoff note, like a SOAP note, for the clinical visit.

5. Patients and their surrogates, family members, and other caregivers are clueless when it comes to what was supposed to happen during the handoff and what actually happened.

6. Handoffs, to be successful, have to be planned and measured. What happens before and after the handoff is as equally important as what happened or did not happen during the hand off.

7. Each stakeholder in the handoff has different pain points and handoff systems don't address them with unique value propositions.

8. Handoff interventions don't pinpoint specific end points, be they clinical or business, to determine their validity.

9. Extramural, open network handoffs create a different set of problems compared to intramural handoffs. Handing a patient off to the unit down the hall is different from handing off a patient for a liver transplant in Mumbai from Montana.

10. Handoff systems need to be easy to use, intuitive, not add substantial workflow burdens, and be effective at achieving clearly defined end-points.

Patients and their families deserve better than to fall through the cracks of the handoff. Like a long distance marathon, everyone should be wearing the same jerseys, understand where, when, and how they should take the baton, and then run with it. Patients’ lives depend on it.