Patient Safety Tool: Safer Sign-Out Form for Patient Handoffs

The Emergency Medicine Patient Safety Foundation offers a free Safer Sign Out form to improve the safety of patient handoffs at the end of a shift.

The Safer Sign Out protocol, originally developed by the Safety Leadership Group of Emergency Medicine Associates in Germantown, Md., is largely based on recommendations from a 2010 American College of Emergency Physicians whitepaper. The protocol involves five key components:

•    Record. Use a form to record and communicate information about the patient, including critical details and follow-up items.
•    Review. The physicians ending and coming on shift should jointly review the form items and computer data.
•    Round together. Both physicians should round on the patient and discuss the handoff with the patient and family.
•    Relay to the team. The physicians should confirm the handoff plan with the nurse and entire patient team.
•    Receive feedback. Use the Safer Sign Out form for clinical follow-up and process quality assurance.

The Safer Sign Out form includes sections for the patient's name and age, a list of problems and key issues, pending items, patient disposition and other notes.

Download the Safer Sign Out form for use in your own facility.

Note: View our database providing more than 400 reports that link to free downloadable and adaptable tools for use in surgery centers, hospitals and other organizations.

More Articles on Patient Handoffs:

Advocate Sherman's Readmission Reduction Journey
5 Takeaways From the Bronx Collaborative's Readmission Initiative
Study: ED Visits Post-Discharge Vary Nearly Twofold Across Hospitals

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