Implementation of a computerized patient handoff application.

For hospitalized patients, handoffs between providers affect continuity of care and increase the risk of medical errors. Most commercial electronic health record (EHR) systems lack dedicated tools to support patient handoff activities. We developed a collaborative application supporting patient handoff that is fully integrated with our commercial EHR. The application creates user-customizable printed reports with automatic inclusion of a variety of EHR data, including: allergies, medications, 24-hour vital signs, recent common laboratory test results, isolation requirements, and code status. It has achieved widespread voluntary use at our institution (6,100 monthly users; 700 daily reports generated), and we have distributed the application to several other institutions using the same EHR. Though originally designed for resident physicians, today about 50% of the application users are nurses, 40% are physicians/physician assistants/nurse practitioners, and 10% are pharmacists, social workers, and other allied health providers.