Handovers & Transfer Protocols

Handoffs/Transfer Protocols

100 % of trainees’ handover/transition of care evaluations must be documented in MedHub
 Step-by-step Instructions on Completing a Handover Evaluation in MedHub

handoff,  also known as “sign-out”, is a real time, active process of passing patient-specific information from one caregiver to another or from one team of caregivers to another for the purpose of ensuring the continuity and safety of the patient’s care.
transfer is a real time, active process of conveying the responsibility for the care of a patient from one entity to another. It may involve the discharge from one entity and the admission to another along with the patient’s medical records or copies.

A standardized approach to handovers/transfers at Stanford Hospital & Clinics provides an opportunity to ask and respond to questions. Caregivers involved in the hand-off process include, but are not limited to, physicians, nurses, therapists, technicians and transporters.
Key elements of patient information are included in the handover/transfer process as determined by the service or team of caregivers.  Patient information related to current condition and present treatment patient information will include at a minimum:

  • Patient name                                   
  • MR #                                                  
  • Diagnosis                                          
  • Allergies
  • Potential changes in condition
  • What to watch for or monitor during the next interval of care


Handoff/transfer communication must be a verbal face-to-face report accompanied by a written handoff/transfer report via templates developed at the unit or departmental level.  Anytime written communication is used in a handoff/transfer, the name and contact number of the caregiver handing off or transferring care will be included to facilitate the asking of questions. Additionally, attending faculty  are available at all times and may be directly contacted.








Illness Severity

  • Stable, “watcher,” unstable


Patient Summary

  • Summary Statement
  • Events leading up to admissions
  • Hospital course
  • Ongoing assessment
  • Plan


Action List

  • To do list
  • Time line and ownership


Situation Awareness and Contingency Plan

  • Know what’s going on
  • Plan for what might happen


Synthesis by Receiver

  • Receiver summarizes what was heard
  • Ask questions
  • Restates key action/ to do items



  • Emphasize a “call tree” during sign out – who is the first line to call if there is an issue and what is the appropriate phone number, who is the second line, etc.
  • Face-to-Face sign out is the gold standard, not brief phone calls or texts
  • Go to bedside for critical patients or patients with active medical issues






ACGME Common Program Requiremen