The Joint Commission – Sentinel Event Alert: Inadequate hand-off communication

Health care professionals typically take great pride and exert painstaking effort to meet patient needs and provide the best possible care. Unfortunately, too often, this diligence and attentiveness falters when the patient is handed off, or transitioned, to another health care provider for continuing care, treatment or services. A common problem regarding hand-offs, or hand-overs, centers on communication: expectations can be out of balance between the sender* of the information and the receiver.1 This misalignment is where the problem often occurs in hand-off communication.

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