The "Warm Handoff" Protocol: Systematic Review of Training to Support Effective Transfers of Care between the Emergency Department and Primary Care
Abstract
Background: Emergency Department-to-primary-care handoff is a high-risk time for breakdown in communication. Asynchronous, written traditional practice, such as instructions, frequently leads to loss of information, threatening patient safety and continuity of care. "Warm Handoff" is a structured, synchronous, verbal handover between clinicians that can be the answer to this critical gap.
Aim: The present systematic review synthesizes the current evidence base (2015-2025) on standardized communication training programs for preparing ED nurses and physicians with the skills required to execute effective warm handoffs directly to clinic-based teams.
Methods: Recent literature was reviewed to examine the critical components of successful training curricula, evaluate their impact on patient, provider, and system outcomes, and identify the most significant implementation challenges and facilitators.
Results: Formal warm handoff training has been shown through evidence to effectively reduce communication errors, improve patient satisfaction and follow-up compliance, decrease unnecessary ED recidivism, and enhance professional satisfaction among both primary and ED staff. However, implementation is threatened by workflow integration, technical support, and interprofessional hierarchies.
Conclusion: Universal adoption and standardization of warm handoff training protocols are essential to building a safer, more reliable, and patient-centered healthcare system, as high as there are significant implementation challenges.
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Authors
Copyright (c) 2025 Abduallah Mohameed Huseen Ayashi, Moayed Abdullah Mohammed Alqarni, Ahlam Mohammed Mose Hakamie, Feras Abdullah Al-Fardan, Ahmad Hassan Albashrawi, Mohammad Jaffar Al Rumaih, Eisa Jafar Morabit, Hassan Mohammed Al Ramadan, Asim Ibrahim Ali Moafa, Shahad Jabbari, Sultan Badah Alharbi, Ishaq Rubayyi Mukhlef Alhazmi
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