Developing a new flexible tool for handover

Racheli Magnezi, Inbal Gazit, Arie Bass, Orna Tal

Research output: Contribution to journalArticlepeer-review


Background: Transferring medical information among professionals and between shifts is a crucial process, allowing continuity of care and safety, especially for complex patients in life-threatening situations. This process, handover, requires focusing on specific, essential medical information while filtering out redundant and unnecessary details. Objectives: To create and implement a tool for handover that would be flexible enough to meet the unique needs of specific departments. Methods: We used Plan-Do-Study-Act (PDSA) methodology to prospectively develop, implement, evaluate and reassess a new handover tool in a 900-bed teaching hospital in central Israel. Nurses from 35 departments participated in developing a tool that presents the staff's viewpoint regarding the most critical information needed for handover. Results: A total of 78 nurse managers and 15 doctors (63.7%) completed the questionnaire. Based on exploratory factor analysis, 15 items explained 58.9% of the variance. Four key areas for handover were identified, in addition to basic patient identification: (i) updated clinical status, (ii) medical information, (iii) special clinical treatment and (iv) treatments not yet initiated. Subsequently, a Flexible Handover Structured Tool (FAST) was designed that identifies patients' needs and is flexible for the specific needs of departments. Revisions based on hands-on experience led to high nurse satisfaction with the new tool in most departments. The FAST format was adopted easily during the COVID-19 pandemic. Conclusion: Implementing a new handover tool - FAST - was challenging, but rewarding. Using PDSA methodology enabled continuous monitoring, oversight and adaptive corrections for better implementation of this new handover reporting tool.

Original languageEnglish
Article numbermzab022
JournalInternational Journal for Quality in Health Care
Issue number1
StatePublished - 20 Feb 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail:


  • PDSA
  • handoff
  • hospital change
  • implementation
  • patient safety
  • quality improvement
  • redesigned handover tool


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