Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Improve Outpatient Handoffs


Consider performing outpatient handoffs and preparing patients when you will be away. This will make your time away easier for your covering colleagues and for your patients.

Much research has focused on the importance of transitions for patients between inpatient teams, or when patients leave the hospital and go home. Outpatient transitions have had less focus, although they are extremely important. These transitions may happen when a clinician goes on vacation or medical leave, or when resident physicians rotate between outpatient and inpatient responsibilities.


What should we consider when making these transitions? Stephanie Nothelle, MD, led our group in studying outpatient resident-to-resident handoffs. Here are some tips to consider:


1.) Signout all of the patients that you are concerned about.

Our study found that residents reported that 15% of their patients were identified as “of concern” to require attention from a covering doctor, but that only 2% of patients had a handoff completed.


2.) Signout should be brief – an email or EHR message to the covering physician is sufficient.


3.) Communicate with your patients.

When I’m traveling or otherwise out of the office, I generally have a few patients who are more “active.” I let them know ahead of time when I will be away and who is covering. This lets them know that another physician knows about them and will be there for them when I can’t be.


Finally, thank the person covering for you! It can take a lot of time and effort to cover for someone, and I really appreciate my colleagues who take care of my patients when I’m away. Sometimes the best way to thank them is to cover for them in return.