Abstract
A handoff is the effective communication of essential information to enable transfer and acceptance of patient responsibility from one clinician (or group of clinicians) to another. These critical exchanges often occur during times of high cognitive load and are frequently plagued with distractions. Poorly executed handoffs are known to contribute to patient harm. Cognitive aids are tools, such as visual aids, mnemonics, or checklists, that are used to aid memory during cognitive tasks, and have been used as a component of many handoff improvement programs. To date, cognitive aids have been used to consistently improve both task adherence and team performance during simulated perioperative crises. Ongoing research is evolving towards relating these improvements with patient outcomes and informing optimal cognitive aid design. Despite limited evidence for applying cognitive aids specifically for handoff improvement, there is broad expert consensus endorsing their use as a component of effective handoffs. Important lessons from cognitive aid design and implementation include the use of a multidisciplinary team, iteratively improving the tool based on feedback, the use of clinician champions, and the importance of leadership support.
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