Handoffs and Patient Safety: Grasping the Story and Painting a Full Picture

Patricia Birmingham, Martha D. Buffum, Mary A. Blegen, Audrey Lyndon

Research output: Contribution to journalArticlepeer-review


Effective handoff communication is critical for patient safety. Research is needed to understand how information processes occurring intra-shift impact handoff effectiveness. The purpose of this qualitative study was to examine medical-surgical nurses’ (n = 21) perspectives about processes that promote and hinder patient safety intra-shift and during handoff. Results indicated that offgoing nurses’ ability to grasp the story intra-shift was essential to convey the full picture during handoff. When oncoming nurses understood the picture being conveyed at the handoff, nurses jointly painted a full picture. Arriving and leaving the handoff with this level of information promoted patient safety. However, intra-shift disruptions often impeded nurses in their processes to grasp the story thus posing risks to patient safety. Improvement efforts need to target the different processes involved in grasping the story and painting a full picture. Future research needs to examine handoff practices and outcomes on units with good and poor practice environments.

Original languageEnglish (US)
Pages (from-to)1458-1478
Number of pages21
JournalWestern Journal of Nursing Research
Issue number11
StatePublished - Nov 1 2015


  • continuity of care
  • handoff
  • handover
  • shift report

ASJC Scopus subject areas

  • General Nursing


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