Editorial: Crawling Before Walking: Beginning to Understand How Clinicians Communicate and Behave During Interunit Handoffs

摘要

The literature on handoffs, which are defined as "the transfer of information, authority, or responsibility" between clinicians is voluminous. However, there has been little comprehension and substantive research on how we communicate and behave during interunit transitions. In fact, there is no clear understanding of the purpose of the handoff in the first place. Interunit transition communication is much more complex than within-unit transitions. A larger host of social, technical, and system issues affect how efficient and effective care is delivered along the continuum. Attempts at understanding those issues and suggestions for improvement have been made. However, the article by Hilligoss and colleagues, "Collaborating-or 'Selling' Patients? A Conceptual Framework for Emergency De-partment-to-Inpatient Handoff Negotiations," which appears in this issue of The Joint Commission Journal on Quality and Patient Safety, goes further, providing an important conceptual framework in which emergency department (ED) admission handoffs are treated as a matter of negotiation. The team of authors should be noted for its diversity and for the collaboration between clinicians as subject-matter experts and social scientists as observers of how clinicians work. Without interdisciplinary collaboration such as this, efforts to comprehend the complexity of how we work will fall short because they will be simplistic, myopic, and, in a fundamental way, uninformed.