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A handoff is not a telegram: an understanding of the patient is co-constructed

Michael D Cohen1*, Brian Hilligoss2 and André Carlos Kajdacsy-Balla Amaral3*

Author Affiliations

1 School of Information, University of Michigan, 3442 North Quad, 105 South State Street, Ann Arbor, MI 48109-1285, USA

2 Division of Health Services Management and Policy, College of Public Health, Ohio State University, 200C Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210-1351, USA

3 Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room D108, Toronto, ON M4N 3M5, Canada

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Critical Care 2011, 16:303  doi:10.1186/cc10536

See related letter by Wise et al.,

Published: 8 February 2012


Hospital handoffs are believed to be a key locus of communication breakdown that can endanger patient safety and undermine quality of care. Substantial new efforts to better understand handoffs and to improve handoff practices are under way. Many such efforts appear to be seriously hampered, however, by an underlying presumption that the essential function of a handoff is one-way information transmission. Here, we examine social science literature that supports a richer framing of handoff conversations, one that characterizes them as co-constructions of an understanding of the patient.