Handoff Communication & Continuity of Care
Overview
Handoff communication is the real-time transfer of patient-specific information AND clinical accountability from one provider to another at a care transition. The Joint Commission's NPSG.02.05.01 requires a standardized, interactive process. It must be a two-way exchange — the receiving nurse asks clarifying questions and reads back critical items (pending labs, titrating drips, time-sensitive meds). If the receiver cannot ask questions, it is a report, not a handoff. Written tools (printed worksheets, EHR summaries) support but never replace the verbal exchange. Accountability stays with the outgoing nurse until the receiving nurse explicitly accepts the handoff.
Indications
Technique
Inter-facility / unit transfer sequence — communicate and document fully BEFORE the patient is physically moved.
Transfer handoff sequence (communicate first, move last)
- Review statusMeds, pending orders
- Prepare documentationSummary + med reconciliation
- Verbal handoffStandardized + read-back
- Prep patient/familySet expectations
- Safe transportMonitor en route
Interpretation
A complete handoff transfers clinical REASONING, not just data — the sender's interpretation of why findings matter and what to anticipate. SBAR is a general communication framework (also used to call a provider); a handoff is the specific structured transfer of care and accountability. Critical content: current condition, recent changes, pending tasks/results, and provider-notification parameters.
Patient Teaching
Clinical Pearl
A standardized, interactive bedside handoff with read-back closes the gap where information — and accountability — gets dropped. If you can't ask questions, it's a report, not a handoff.