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Verbal Handoff Assessment - Single - Demo
   

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Verbal Handoff Assessment – Single

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Verbal Handoff Assessment – SingleChristina2017-03-02T15:41:09+00:00

Verbal Handoff Assessment (SINGLE patient)

    Choose the unit where your observation took place.
    Choose the unit where your observation took place.

  • Verbal Handoff Assessment Tool-Single

  • NoYes
    I. Illness Severity
    P. Patient Summary
    A. Action List
    S. Situation Awareness/Contingency Planning
    S. Synthesis by Receiver
    I. Illness Severity: Identification as stable, "watcher", or unstable; must occur at the beginning of each patient handoff.
     
    P. Patient Summary: Might include summary statement, events leading up to admission, hospital course, ongoing assessment, plan.
     
    A. Action list: To do list; (must be separated from patient summary).
     
    S. Situation Awareness/Contingency Planning: Know what’s going on; plan for what might happen.
     
    S. Synthesis by Receiver: Written reminder to prompt receiver to summarize what was heard during verbal handoff.
  • NoYes
    Giver actively engaged with receiver to ensure understanding of patients
    Giver appropriately prioritized key information, concerns, or actions
    Provided to-do list restricted to items that need to be accomplished on next shift
    Used high quality contingency plans with clear if/then format
  • YesNo
  • Unable to evaluateDoes NOT yet meet high standardMeets high standard
    Patient Summary
    Synthesis by the receiver
  • For HIPAA compliance, patient-specific information should NOT be entered in to this form.
  • For HIPAA compliance, patient-specific information should NOT be entered in to this form.
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