E1358. Passing the Baton: Effective Handoffs in Radiology Practice
  1. Sarah Ciccarelli; Albert Einstein College of Medicine
  2. Edward Mardakhaev; North Shore University Hospital
  3. Amichai Erdfarb; Montefiore Medical Center
  4. Shlomit Goldberg-Stein; Montefiore Medical Center
  5. Judah Burns; Montefiore Medical Center
Prevention of medical errors focuses on identifying underlying causes of error and developing mitigating strategies. The paradigm shifts towards just culture and high-reliability systems recognizes communication errors as a leading root cause of adverse events, with handoff communication specifically identified as one of the biggest communication challenges. Care transitions involving handoffs occur with high incidence and are associated with a high risk of adverse outcomes. There is ample research regarding handoffs across subspecialties of medicine, surgery, and nursing, but attention is lacking within the field of radiology. With focus on high-reliability strategies for error prevention, published strategies for maintaining effective handoffs in medical and nursing practices can be applied in radiology practice.

Educational Goals / Teaching Points
Our primary educational goal is to demonstrate the prevalence of handoff communications in radiology and offer handoff improvement strategies applicable to radiology practice. We will review effective handoff improvement strategies from other representative high-reliability systems.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will discuss examples of handoff communications which occur in radiology practice and apply high-reliability improvement strategies across individual, team, and organizational levels. Handoffs in radiology reflect patient-oriented communications and include but are not limited to orders, protocols, physical transfers, curbside consults, written reports, critical results reports, and resident sign-outs. At the individual level, the use of established frameworks to consistently convey severity, urgency, background information, action lists, recommendations, and contingency plans ensures completeness and minimizes variation. Standardization can be applied in verbal handoffs as well as in structured written reports, post-procedure notes, and communication documentation. The combination of this strategy with face-to-face interactions and closed loop communication techniques can be further supported by team level interventions such as designated time for handoff without interruption and by organizational interventions using automation such as EHR templates, computerized order entry systems, and critical test results management systems.

Handoffs are a major communication challenge and source of error among medical professionals, and the frequency of handoffs in radiology underscores the importance of using evidence-based strategies to improve its effectiveness. Mindfully layered interventions at individual, team, and organizational levels are necessary for making handoff a safe and highly reliable practice.