ECCCHO: Effective Combat Casualty Care Handoff Operations

Approximately 70% of sentinel events in medical care are related to communication mishaps, and despite regular and frequent occurrence, an even higher percentage (80%) of severe medical errors are related to miscommunication during handoffs (i.e., the transferring of information, responsibility, and authority for patient care from one provider to another). The TiER1 team proposes to address challenges related standardized handoff protocols, validation of those protocols, and transfer of evidence-based approaches to the field. To address these challenges, we propose to develop the Effective Combat Casualty Care Handoff Operations (ECCCHO) system. Three components comprise the ECCCHO system: (1) The Toolkit including mnemonics and a digital Tactical Combat Casualty Care (TCCC) Card to ensure the right elements accompany a handoff; (2) The Methoddrawn from team performance research and applications, current best practices in patient handoffs, and TiER1s approach to addressing performance and organizational gaps in Fortune 500 companies; and (3) Outcome measures against which methods and elements of handoff protocols can be evaluated. The Toolkit will include what (required elements) to communicate as specified by DHA Procedural Instruction Number 6040.01, and the Method will specify how (process) to communicate during handoffs throughout the continuum of care.