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The Labor and Delivery Unit is characterized by collaboration between multiple teams, high information output, and rapidly evolving changes in patient conditions. A comprehensive handoff, i.e., transition of care, facilitates communication among teams, continuity of care, and patient safety. Accreditation Council for Graduate Medical Education (ACGME) emphasizes the proper training of “Structured and Effective Transition of Care.”1,2


When Does the Handoff Occur?

  • Shift changes

  • When provider(s) changes during a surgery

  • When the patient is transferred to the Postanesthesia Care Unit (PACU) or Intensive Care Unit (ICU); Chapter 53, “Postanesthetic Care”

Who Needs a Handoff?

  • Every patient in Labor and Delivery Unit

  • Every patient in PACU

  • Any patients who need follow-up on the postpartum floors or as an outpatient

  • Any antepartum patients who may need potential urgent anesthesia care

  • Any patient admitted to ICU

How to Handoff?

The comprehensive handoff includes “General Information” and “Specific Information” (Table 32-1).

TABLE 32-1Handoff Script for Obstetric Patients


1. +
VI.E.3. Transitions of care. ACGME program requirements for graduate medical education in anesthesiology 2022. Accessed in December 2022.
2. +
Agarwala  AV, Lane-Fall  MB, Greilich  PE,  et al. Consensus recommendations for the conduct, training, implementation, and research of perioperative handoffs. Anesth Anal. 2019;128(5):e71–e78.

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