Doctors and office staff discuss patient handoffs.

How to Successfully Transition Patient Handoffs

Handoffs, or transfers of care, present a perfect opportunity to reinforce your commitment to strong, safe, and quality doctor-patient relationships.

Communication is critical during a handoff period, however many times handoffs are not carried out adequately, therefore sabotaging the very safe, quality relationship you are trying to enhance.

The Joint Commission references three factors contributing to ineffective transitions of care. They include:

  • Communication Breakdowns
  • Patient Education Breakdowns
  • Accountability Breakdowns

To ensure your handoffs transition smoothly, try the I PASS THE BATON technique mentioned below.

Introducing the I PASS THE BATON Technique

One way to improve the transfers of care is to utilize the I PASS THE BATON technique.  This technique was adopted from the Department of Defense Safety Program, “Healthcare Communications Toolkit to Improve Transitions in Care,” to provide structure for improved communications, specifically during transitions of care.  The acronym stands for:

I – Introduction                 (identify each individual involved and their roles)

P – Patient                          (name, identifiers, age, sex and location)

A – Assessment                (present chief complaint, vital signs, symptoms and diagnosis)  

S – Situation                       (current status and circumstances, including code status, level of certainty or uncertainty, recent changes and response to treatment)

S – Safety Concerns        (critical lab values and reports, socioeconomic factors, allergies, alerts)


B – Background                 (co-morbidities, previous episodes, current medications and family history)

A – Actions                         (detail what actions have been taken or are required along with rationale for those actions)

T – Timing                            (level of urgency and explicit timing, prioritizing of actions)

O - Ownership                   (who is responsible, including the patient and family responsibilities)

N – Next                              (what will happen next, anticipated changes, the plan as well as contingency plans)

Whether patients are outbound from your office to another provider or inbound to your office, you can complement the mnemonic with clear policies and procedures such as:

  • Discussing and documenting the reason for the transition in care with the patient and, if appropriate, family members
  • Establishing communication with the consultant at the time of referral
    • Confirming the new provider will accept the patient and the corresponding responsibility
    • Assisting the patient in making the appointment with the provider
    • Transmitting necessary information
    • Confirming transmitted information was received
  • Following up on the consultation for coordinating care, monitoring treatment and ensuring continuity of care
  • Initiating and consistently using a tracking system to assure reports are received/reviewed from the specialist and appropriate action is initiated.
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