The Particulars: Research has shown that ED admission handoffs have unique structural and contextual challenges that require optimal communication between ED and hospital providers. These challenges can sometimes include changes in providers, departments, and physical locations when a patient’s clinical trajectory is uncertain. Few studies have assessed barriers to effective communication during ED admission handoffs.

Data Breakdown: A survey found that ED physicians reported communicating clinical information less frequently than admitting physicians. Nearly all ED physicians felt they had to defend their decisions, and many noted that face-to-face communication was rare. Clinical duties distracted physicians frequently during handoffs, whereas environmental factors more commonly distracted ED providers. The least frequently communicated content areas were treatments initiated in the ED (71.9%), trends in the patient’s clinical condition (57.3%), and pending studies (34.8%)

Take Home Pearls: Although most clinical information appears to be communicated regularly during ED admission handoffs, ED and admitting providers appear to have different perceptions on communication. Efforts to improve handoffs should be multifaceted and include inter-disciplinary team building.