- Charge Nurse
- Chief Nursing Officer
- Chief Nursing Officer
- Nurse Team Leader
- Director of Nursing
- Director of Nursing
Hospital nursing is more complex than ever
And bedside nurses are feeling burned out
Nurses will hand off patients more than 100,000 times this year at your hospital
(For hospitals with 150+ beds)
High-reliability hospitals can’t afford to let things fall through the cracks
Unstructured = Unsafe
For 160 years, nursing has advanced by elevating tasks into elite competencies
With specific skills to learn, practice, and verify
Nurses prefer standardized
“Everyone used to have their own script for handover, some were lengthy, others didn’t give enough information. Bedside handover has given us structure and everyone’s on the same wavelength.”
– Kristen, 6A South
“It helps me be succinct and get out all the right information.“
– Jordan, Trainee Nurse, CCU
“It’s faster. It’s more organized. Definitely a time saver. I think it’s cut report down by 15 minutes.”
– Robin, 2-East
Trusted by leading hospitals and health systems
Change the first 20 minutes of each shift,
and you change the culture of your unit
There’s great power in beginnings.
Then structure the Bedside Handover
- Outgoing nurse hands over care at bedside with patient invited to participate
- Standardized for safer, more efficient clinical handover
- Warm, professional, brief (2-5 min)
- Ensures oncoming nurse starts shift with all info needed for continuity and safety
- Learn more ➔
Our nurses didn’t feel like a team. We started each shift more like a group of individuals running around.
So we began a Change of Shift Huddle. Takes 3 minutes. The off-going charge nurse reads through a standard form to the oncoming shift.
It’s the most professional, efficient team meeting you’ll see anywhere in the hospital.
And it starts with a 1-page form. You can use ours. Tens of thousands of nursing shifts have used it.
Change of Shift Huddle videos
Why nurses like it
What it is
Frequently Asked Questions (FAQs)
about Change of Shift Huddle
As nurses, we dread getting bad handoff. When there’s no structure, each nurse gives report their own way. It feels less safe and more stressful — extra stress we don’t need.
So our units decided to standardize each bedside handover.
The heart of our handover is a structured, single-page shift report form. It uses an ISBAR framework, Review of Systems outline, and it’s customized for the unit. And it’s presented top to bottom by the outgoing nurse, then handed over with our patient.
Our nurses much prefer this nurse-designed form over the EMR and its overstuffed SBAR screen.
We believe standardized nursing communication should be made as easy as possible. The best tools simplify what’s complex, without losing detail.
Request a briefing to learn how your units can get going in under 60 days.
Here’s what’s different about a Structured Bedside Handover
Bedside Handover videos
Why nurses like it
What it is
FAQs about Bedside Handover
When our units first started Bedside Handover, it was just OK. We used a standard form, but handover wasn’t consistent.
(That’s because just having a policy – and having it performed with excellence on the front lines – can be two different realities.)
So we changed our perspective – elevating Bedside Handover from a task to a skill with purpose that we practice every shift. And nurses are experts at mastering new skills. The winning recipe is the same: Learning, Practice, and Feedback
- One key was making a list of 9 high-performance behaviors that make Bedside Handover go really well for everyone.
- We then set a goal for our unit to achieve Bedside Handover Excellence, which means all our nurses are verified as expert in Bedside Handover.
And that’s what made it stick. Now we notice a better start and end to our shifts, better use of everyone’s time, and better care – both for our patients and each other.
Bedside Handover Excellence video
FAQs about Bedside Handover Excellence
A Stronger Culture of Patient Safety is Achievable
“The Joint Commission has identified communication as the top contributing factor to medical error, with handoffs playing a role in an estimated 80% of serious preventable adverse events.“
– The Joint Commission
The assurance of quality and safety is the single most significant responsibility of leaders in healthcare delivery. It’s a cornerstone of our careers.
The hand-off process is pivotal to patient safety. Many breaches of patient safety occur around change-of-shift.
Most hospitals have adopted some level of bedside handover by now. But telling nurses to give report at the bedside doesn’t reduce unnecessary variation. Every nurse has their own way of giving report. Nursing handover is typically inconsistent and unstructured.
Let’s review the evidence base:
Structured, nurse-designed communication is better
Acute care today is complex. But quality in complex systems is never the default. It must be designed. The best tools simplify what’s complex, without losing detail.
Structure by itself is not enough. The SBAR or “handover” screen in an EMR has a structure — but it’s far from an ideal tool. Nurses are practical — we only want stuff that works.
That’s why any tool deployed across a hospital needs a pedigree — years of thoughtful iteration, tested and refined by thousands of nurses across hundreds of units.
Standardized, patient-centered communication is safer
Errors arise from unnecessary variation. Standardized communication is the answer.
The literature is clear: To reduce patient harm, we want to use the same tool for each bedside handover.
Here’s what’s worked for us:
Nurses First aligns with several national efforts
High Patient Satisfaction Scores Are Achievable
It’s a natural result of hardwiring a daily “wow moment” for each patient
HCAHPS scores are driven by “top box” positive responses. But it’s hard to impress every patient every day. (And asking stressed-out nurses to also be “customer service agents” isn’t the best approach.)
What if there was a trick to hardwire a daily “wow moment” for each patient? And what if that trick also made nursing handoff more efficient and safe?
Structured Bedside Handover creates that daily “wow moment.” We do it because it’s better for nurses and safer for patients, but it also boosts HCAHPS scores for nursing communication.
For example, look at what happened in 2019 when a med-surg unit at a Southwestern US hospital implemented our Nurses First program.
Before the program, scores for “Nursing Communication” and “Rate the Hospital” were in the low single-digit percentiles. But after achieving Bedside Handover Excellence, they saw HCAHPS scores jump to the 81st and 89th percentiles:
Click image to zoom in
When every nursing handover is a “wow moment,” patients notice.
A Structured Bedside Handover gives patients what they want: Clarity, thoroughness, and empowerment.
It’s unfair. We nurses already do all that. But we often don’t get credit for it.
A warm, super-professional handover helps us get credit in the eyes of patients for all the things we’re already doing.
And for nurses, that overdue recognition feels rewarding.
Schedule a briefing to learn how to boost patient satisfaction scores on your units:
Higher Nursing Satisfaction Is Achievable
No Bad Handoffs ➔ Better Shifts ➔ Happier Nurses
We’re living in a new era. Hospital nursing is more complex than ever — and 1-out-of-2 bedside nurses now say they’re burnt out. Turnover rates are spiking.
Nurses choose hospitals that find meaningful ways to care for them — and we leave the ones that don’t. We prefer hospitals that:
- Reduce our stress
- Help us get familiar with our patients as quickly as possible
- Reduce unnecessary variation in communication
- Make us feel part of a high-performing team and a collaborative work culture
“When you get good report, your day will be better.”
– Walela, Bedside Nurse
The best way to support nurses is to give us the resources we need to do our best work. That includes an efficient, standardized handover that lets us hit the ground running — wasting less time searching for information, and more time for what we like to do: problem solving and proactively getting ahead in our day.
Less stress can mean lower turnover. Nursing turnover fell to less than 3% on the unit where we first developed our standardized communication processes.
Behaviors become habits, and habits become culture.
You’re already doing a lot to support your nurses. You can get the most of those efforts by transforming the most stressful part of a nursing shift — the first 30 minutes — with an efficient Change of Shift Huddle and a Structured Bedside Handover.
It’s a straightforward way to support your nurses — at a time when they need it the most.
As you think about your own change of shift, any questions that we can answer for you?
See results in under 60 days
When we help hospitals, we take them through 3 steps to achieve excellence in under 60 days:
- Get everything ready
- Achieve and sustain excellence
We provide all the support needed to achieve Bedside Handover Excellence on each participating unit. Up to 12 units at a hospital can launch together.
We rolled out hospital-wide almost overnight. We were able to embed the same process for change of shift in every unit. We were able to free our nurses to focus on care, not information gathering.
— CNO at a 600-bed US hospital
Can my units do it ourselves?
Yes. To succeed with a homegrown approach, you’ll want these 15 ingredients, and you’ll typically need 3-6 months and a few dedicated staff.
Deciding if homegrown is right for you? Set up a 1:1 conversation with our CNO who can help you ask the right questions:
Why We Do This
Your patients are our patients.
We help take care of them by giving you up-to-date access to tools and best practices, and by helping you make them work for your hospital.
It’s a privilege to share this information with you. Thank you for the chance to support you and your nurses in the care of their patients.