Handoffs in the intensive care unit

Background: Effective handoffs in the intensive care unit (ICU) are key to patient safety. Purpose: This article aims to raise awareness of the significance of structured and thorough handoffs and highlights possible challenges as well as means for improvement. Materials and methods: Based on the available literature, the evidence regarding handoffs in ICUs is summarized and suggestions for practical implementation are derived. Results: The quality of handoffs has an impact on patient safety. At the same time, communication in the intensive care setting is particularly challenging due to the complexity of cases, a disruptive work environment, and a multitude of inter- and intraprofessional interactions. Hierarchical team structures, deficiencies in feedback and error-management culture, (technical) language barriers in communication, as well as substantial physical and psychological stress may negatively influence the effectiveness of handoffs. Sets of interventions such as the implementation of checklists, mnemonics, and communication workshops contribute to a more structured and thorough handoff process and have the potential to significantly improve patient safety. Conclusion: Effective handoffs are the cornerstone of high-quality and safe patient care but face particular challenges in ICUs. Interventional measures such as structuring handoff concepts and periodic communication trainings can help to improve handoffs and thus increase patient safety.