Results of a 2014 survey on clinical handoff among physicians in a North Italian Academic Hospital

Background: Transferring essential information and responsibility for patient care from one health care provider to another is an integral component of patient safety in a hospital. This study aims to collect physicians’ interests and needs about handoff before the introduction of a hospital standardized tool in a North Eastern Italian Academic Hospital (AH). Methods: From October to December 2014 all physicians working in the AH were asked to fill a web-based questionnaire concerning currently adopted methods to transfer patient information during shift change and their perception on handoff issues. Results: Response rate was 10.5% (90/853). 63.3% (57/90) of physicians showed maximal agreement with the statement “communication failures are related to adverse events” and 40% (36/90) of them completely agreed that “improving handoff makes work safer”. Among actually used handoff methods (total answers: 157), verbal communication was referred 45.2% times, written notes 26.1%, electronic supports 21.7%, standardized checklists 2.5% and instant messaging 2.5%. The most frequently reported obstacles to an effective handoff (127 answers) were interruptions (22.8%), absence of written hospital protocols (21.3%) and colleague’s inability to provide further information when required (15%). Lack of communication with nurses was referred by 36.7% (33/90) of physicians. Respondents interested to test a new handoff procedure were 48.9% (44/90). Conclusions: The low response rate and the fact that only half of respondents were interested in experimenting a new procedure stress the little relevance given by physicians to handoff as a key process for patient safety. Furthermore, hazardous methods of transferring information such as verbal communication and non-structured text, combined with referred handoff obstacles, suggest the necessity of developing a hospital policy for clinical handoff between physicians.