Transitions of Care / Handoffs


Department of Neurological Surgery – Residency Program Policy

Policy: Transitions of Care / Handoffs

Program Chair: Michael Rosner, MD

Last Revision: March 11, 2020


To ensure that all residents in Neurological Surgery are provided with a defined process to safely and accurately convey important information about a patient’s care when transferring care responsibilities from one physician to another.


A structured handoff is the process of transferring information, authority, and responsibility for patients during transitions of care.  Transitions include changes in providers (shift-to-shift, service-to-service) or movement of a patient from one location or level of service to another level of care.


  1. The primary objective of a “hand-off” is to provide succinct and accurate information about a patient’s current condition and treatment plan, such that there are no delays in treatment, progression to care goals, or adverse events to the patient.
  2. Hand-offs will occur as follows:
Time Event Location Team Members Present (Minimum)
M-F 6:30am Team Rounds GWUH Radiology
  • Chief Resident
  • PGY-2 Service Resident
  • Post-Call Resident
  • Attending On-Call (Supervisor)
M-F 7:20am Resident to PA Handoff Pre-Op/PACU
  • Chief Resident (Supervisor)
  • Service Resident(s)
  • Service Intern(s)
  • Service Mid-Level(s)
M-F 3:00pm PA to Resident Handoff Resident Office (GWUH 3rd Floor)
  • Service Mid-Level(s)
  • Service Resident(s)
M-F 6:00pm Resident to On-Call Resident Handoff Resident Office (GWUH 3rd Floor)
  • Chief Resident (Supervisor)
  • Service Resident(s)
  1. Paper work for hand-offs will be obtained from the Electronic Health Records (Cerner), which provide a “pre-populated” template for hand-offs.
  2. The information communicated during a hand-off must be accurate in order to meet patient safety goals.
  3. There must be adequate time for questioning between the giver and receiver of patient information.
  4. There must be a verification of the received information, including repeat-back or read-back, as appropriate.
  5. This process will include an opportunity for the receiver of the hand-off information to review relevant patient historical data, which may include previous care, treatment and services.
  6. Interruptions during a hand-off will be limited to minimize the possibility that information fails to be conveyed or may be forgotten.
  7. At least one hand-off each day (typically morning team rounds) will be supervised by an Attending Physician to ensure patient safety, and provide opportunity for feedback to those performing the hand-off. These observations will be incorporated into the resident milestone evaluation.

Approved by GMEC: 4/20/2020