Supplemental Digital Content
Table 1. Summary of Six Additional Handoff Mnemonics Identified From Literature Review Mnemonic Description Details (when available)
HANDOFF 33 H History A Allergies /
medicines N New test results D Differential O Ongoing issues F Finalizing care F Further concerns
(question / answer period)
Question / answer period
HANDOFFS 22 H Hello Introduce caregiver, title, responsibilities and patient A Assessment Chief complaint, pain scale, vital signs, symptoms,
diagnosis and abnormal findings N Necessary patient
information
Name, age, gender, location, social security number and other identifiers
D Danger or risks Allergies, isolation, critical lab values to be recorded and fall precautions
O Occurrence Current status, medications, code status, fluids, intake, output, IV access and response to treatment F Framework History of patient, background, prior treatments,
previous problems, current medications and family medical history
F Future
recommendations
Future treatments for patient S Seek questions Questions and inquiries I-PASS 34,35 I Illness severity Stable, watch or unstable
P Patient summary Summary statement, events leading to admission, hospital course, ongoing assessment and plan A Action list To do list, ownership and timeline
S Situation awareness and contingency planning
Know what’s going on and plan for what might happen
S Synthesis by receiver
Receiver summarizes what was heard, asks questions and restates key actions (to do list) I-SHAPED 36 I Introduce Introduce incoming nurse and verify patients
identity
S Story Review events or circumstances that prompted patients admission, include diagnosis and reasons for admission
Mnemonic Description Details (when available)
H History Patients medical history, details relevant to this hospitalization
A Assessment Current condition, status, and systems review based on clinical status
P Plan Plan of care, including daily goals or shift goals, discharge plan, and core measures (if applicable) E Error Prevention Potential safety issues, communicate high risk and
critical information including precautions D Dialogue Discussion, questions and feedback
RHAPP 37 R Reason Basics of patient current information and condition H History Context, objective data and patients current
condition
A Assessment Summarize current health status issues
P Progress Relate current health status and issues to patients progress (goals & plan of care)
P Plan Follow up care needs and interventions SBAR +2
(ISBARQ) 8
I Introduction Individuals in handoff identify themselves, roles and jobs
S Situation Complaints, diagnosis, treatment plan and patients wants and needs
B Background Vitals, code status, list of medication and lab results A Assessment Care providers assessment of the situation
R Recommendation Pending labs results, what needs to be done in the near future and recommendations for care
Q Questions opportunity to ask questions
