>> Narrator: Engaging patients and their families can improve patient safety in the primary
care environment.
[Card: Warm Handoff]
>> Narrator: One way to do this is through the use of a warm hand off.
A warm handoff is a handoff conducted in person between two members of the healthcare team
in front of the patient and family or caregiver.
A warm handoff is similar in concept to nurse bedside shift report and engages the patient
as a member of the team so that he or she can speak up, ask questions and clarify information.
>> Doctor: Hey, John.
how are you doing?
>> John: I'm doing all right, doc.
>> Amelia: Mr. Winston is now a proud grandpa.
>> Doctor: Oh, that's right.
How's your son's family doing?
I bet it's exciting having a new grandbaby in the family.
>> John: Oh yeah, it is, they're doing great.
Thanks for asking.
By the way, this is my daughter, Sue, she helps me with my medical stuff.
>> Doctor: Welcome Sue, nice to meet you.
So let's have your report Amelia.
>> Amelia: Well, Mr. Winston said he experienced an episode of a rapid heartbeat while he was
working at home two nights ago.
When his heartbeat wouldn't slow down, he went to the emergency room and they kept him
overnight for additional testing and observation.
They diagnosed him with atrial fibrillation and prescribed Xarelto, 10 milligrams to prevent
stroke.
There's no history of a-fib in his charts, his pulse is 52 and his blood pressure today
is 135 over 80 and he's lost five pounds since he was last here two months ago.
He's still taking his Lipitor for his cholesterol.
>> Doctor: Rapid heartbeat.
And this never happened to you before.
>> John: Well, it has, I just didn't tell anyone about it.
>> Sue: Dad, why didn't you tell me?
>> John: Well, it was such a small thing, I didn't want to worry you about it and it
stopped on its own so I thought everything was okay.
>> Doctor: I want to hear what happened both times.
Let's start with what happened two nights ago.
>> John: Okay, so a couple of nights ago, I got home from work.
[Card: Improve communication; Encourage engagement and questions from patients and caregivers]
>> Narrator: Warm handoffs improve communication, encourage engagement and questions from patients
and caregivers
[Card: Allow patients to clarify or correct information]
>> Narrator: ...allow patients to clarify or correct information...
[Card: Build Relationships; Provide a safety check]
>> Narrator: build relationships, provide a safety check.
As you'll see next, even a passing comment can lead to the identification of safety risks.
>> Doctor: Amelia, do you have any information from the hospital?
>> Amelia: I got the hospital to fax over the discharge summary and Mr. Winston brought
his discharge instructions in with him.
>> Doctor: That's great.
>> Amelia: Mr. Winston was seen by Dr. Ortez, the attending cardiologist at 10:15 on Tuesday
night.
After Mr. Winston was diagnosed with atrial fibrillation, he was prescribed Xarelto, 10
milligrams once a day which Mr. Winston says he's filled today and has started taking.
>> John: That makes sense but I was told three times a day, not once a day.
>> Doctor: May I see the discharge summary please?
The blood thinner Dr. Ortez prescribes is only taken once a day.
The instructions from the cardiologist says you need blood work in three months, maybe
that's where things got mixed up.
You take one pill once a day with your evening meal and in three months you come back in
for blood work and we'll see how things are going.
>> John: That makes sense, but this thing is kind of confusing.
>> Doctor: Just to be safe, I want to make sure we're all on the same page.
Can you tell me how you're supposed to take these pills?
>> John: I take one of these pills, Xarelto once a day at dinner time.
>> Doctor: Yes.
>> Sue: Can he take it in the morning at breakfast?
>> Doctor: No, this should be taken in the evening and it's important to take it with
food.
Okay, now let's take a look at you.
Thank you, Amelia.
>> Amelia: It was so nice seeing you both.
>> Narrator: The warm handoff is a tool that primary care practices can use to better engage
patients and families and to improve communication.
This can lead to
[Card: The warm handoff can lead to: safer care; better understanding; greater satisfaction]
>> Narrator: safer care, better patient understanding and greater patient satisfaction.