Literature DB >> 19390111

Evaluation of a physician informatics tool to improve patient handoffs.

Mindy E Flanagan1, Emily S Patterson, Richard M Frankel, Bradley N Doebbeling.   

Abstract

OBJECTIVE To facilitate patient handoffs between physicians, the computerized patient handoff tool (PHT) extracts information from the electronic health record to populate a form that is printed and given to the cross-cover physician. OBJECTIVES were to: (1) evaluate the rate at which data elements of interest were extracted from the electronic health record into the PHT, (2) assess the frequency for needing information beyond that contained in the PHT and where obtained, (3) assess physician's perceptions of the PHT, (4) identify opportunities for improvement. DESIGN Observational study. MEASUREMENTS This multi-method study included content coding of PHT forms, end of shift surveys of cross-cover resident physicians, and semi-structured interviews to identify opportunities for improvement. Thirty-five of 42 internal medicine resident physicians participated. Measures included: 1264 PHT forms coded for type of information, 63 end-of-shift surveys of cross-cover residents (residents could participate 2 times), and 18 semi-structured interviews. RESULTS For objective 1, patient identifiers and medications were reliably extracted (>98%). Other types of information-allergies and code status-were more variable (<50%). For objective 2, nearly a quarter of respondents required information from physician notes not available in the PHT. For objective 3, respondents found that the PHT supported handoffs but indicated that it often excluded the assessment and plan. For objective 4, residents suggested including treatment plans. CONCLUSIONS The PHT reliably extracts information from the electronic health record. Respondents found the PHT to be suitable, although opportunities for improvement were identified.

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Year:  2009        PMID: 19390111      PMCID: PMC2705254          DOI: 10.1197/jamia.M2892

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  10 in total

1.  Residents' suggestions for reducing errors in teaching hospitals.

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2.  Statistical analysis of correlated data using generalized estimating equations: an orientation.

Authors:  James A Hanley; Abdissa Negassa; Michael D deB Edwardes; Janet E Forrester
Journal:  Am J Epidemiol       Date:  2003-02-15       Impact factor: 4.897

3.  Handoff strategies in settings with high consequences for failure: lessons for health care operations.

Authors:  Emily S Patterson; Emilie M Roth; David D Woods; Renée Chow; José Orlando Gomes
Journal:  Int J Qual Health Care       Date:  2004-04       Impact factor: 2.038

4.  Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis.

Authors:  V Arora; J Johnson; D Lovinger; H J Humphrey; D O Meltzer
Journal:  Qual Saf Health Care       Date:  2005-12

5.  Post-call transfer of resident responsibility: its effect on patient care.

Authors:  R P Lofgren; D Gottlieb; R A Williams; E C Rich
Journal:  J Gen Intern Med       Date:  1990 Nov-Dec       Impact factor: 5.128

6.  Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs.

Authors:  Darrell J Solet; J Michael Norvell; Gale H Rutan; Richard M Frankel
Journal:  Acad Med       Date:  2005-12       Impact factor: 6.893

7.  A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours.

Authors:  Erik G Van Eaton; Karen D Horvath; William B Lober; Anthony J Rossini; Carlos A Pellegrini
Journal:  J Am Coll Surg       Date:  2005-04       Impact factor: 6.113

8.  Using a computerized sign-out program to improve continuity of inpatient care and prevent adverse events.

Authors:  L A Petersen; E J Orav; J M Teich; A C O'Neil; T A Brennan
Journal:  Jt Comm J Qual Improv       Date:  1998-02

Review 9.  A model for building a standardized hand-off protocol.

Authors:  Vineet Arora; Julie Johnson
Journal:  Jt Comm J Qual Patient Saf       Date:  2006-11

10.  Does housestaff discontinuity of care increase the risk for preventable adverse events?

Authors:  L A Petersen; T A Brennan; A C O'Neil; E F Cook; T H Lee
Journal:  Ann Intern Med       Date:  1994-12-01       Impact factor: 25.391

  10 in total
  25 in total

1.  In search of common ground in handoff documentation in an Intensive Care Unit.

Authors:  Sarah A Collins; Lena Mamykina; Desmond Jordan; Dan M Stein; Alisabeth Shine; Paul Reyfman; David Kaufman
Journal:  J Biomed Inform       Date:  2011-11-28       Impact factor: 6.317

2.  Trends in biomedical informatics: most cited topics from recent years.

Authors:  Hyeon-Eui Kim; Xiaoqian Jiang; Jihoon Kim; Lucila Ohno-Machado
Journal:  J Am Med Inform Assoc       Date:  2011-12       Impact factor: 4.497

3.  Sign-out snapshot: cross-sectional evaluation of written sign-outs among specialties.

Authors:  Amy R Schoenfeld; Mohammed Salim Al-Damluji; Leora I Horwitz
Journal:  BMJ Qual Saf       Date:  2013-08-30       Impact factor: 7.035

4.  An intervention to improve ambulatory care handoffs at the end of residency.

Authors:  Michael J Donnelly; Janelle M Clauser; Neil J Weissman
Journal:  J Grad Med Educ       Date:  2012-09

Review 5.  A systematic review of the literature on the evaluation of handoff tools: implications for research and practice.

Authors:  Joanna Abraham; Thomas Kannampallil; Vimla L Patel
Journal:  J Am Med Inform Assoc       Date:  2013-05-23       Impact factor: 4.497

6.  Current Practice in End-of-Residency Handoffs: A Survey of Internal Medicine-Pediatrics Program Directors.

Authors:  Michael J Donnelly; Janelle M Clauser; Rochelle E Tractenberg
Journal:  J Grad Med Educ       Date:  2013-03

7.  The patient handoff: a comprehensive curricular blueprint for resident education to improve continuity of care.

Authors:  Max V Wohlauer; Vineet M Arora; Leora I Horwitz; Ellen J Bass; Sean E Mahar; Ingrid Philibert
Journal:  Acad Med       Date:  2012-04       Impact factor: 6.893

8.  Ensuring patient safety in care transitions: an empirical evaluation of a Handoff Intervention Tool.

Authors:  Joanna Abraham; Thomas Kannampallil; Bela Patel; Khalid Almoosa; Vimla L Patel
Journal:  AMIA Annu Symp Proc       Date:  2012-11-03

9.  An institution-wide handoff task force to standardise and improve physician handoffs.

Authors:  Leora I Horwitz; Kevin M Schuster; Stephen F Thung; David C Hersh; Rosemarie L Fisher; Nidhi Shah; William Cushing; Judy Nunes; David G Silverman; Grace Y Jenq
Journal:  BMJ Qual Saf       Date:  2012-05-23       Impact factor: 7.035

10.  Implementation of a computerized patient handoff application.

Authors:  David K Vawdrey; Daniel M Stein; Matthew R Fred; Susan B Bostwick; Peter D Stetson
Journal:  AMIA Annu Symp Proc       Date:  2013-11-16
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