Literature DB >> 21242451

Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results.

Dana A Telem1, Kerri E Buch, Steven Ellis, Brian Coakley, Celia M Divino.   

Abstract

HYPOTHESIS: The Situation, Background, Assessment, and Recommendation model (SBAR) provides an excellent framework for communication in daily resident handoffs.
OBJECTIVE: To evaluate implementation of SBAR into the surgical curriculum.
DESIGN: A curriculum using video and role-play scenarios to augment a didactic lecture on SBAR was implemented for general surgery residents. Resident assessment was achieved via an anonymous survey administered after training. Outcome was evaluated by assessing sentinel events and resident order entry 30 days before and after training. Surgical subspecialty resident order entries were used as controls. Duplicated, cancelled, and wrong patient orders were attributed to failed communication.
SETTING: Academic department of surgery. PARTICIPANTS: Forty-five general surgery residents at our institution.
RESULTS: Survey response rate was 100%. Poor communication was identified as the leading cause of handoff failure, with nurse-to-resident handoffs considered the most problematic. Overall, the curriculum was well received. Outcomes analysis demonstrated no difference in sentinel events. A 2.3% decrease in pretraining and posttraining order entry errors (14.5% vs 12.2%; P = .003) was demonstrated. No difference was demonstrated in controls who did not undergo SBAR training (12.9% vs 13.6%; P = .47).
CONCLUSIONS: Most of the residents indicate that the SBAR curriculum addressed frequently encountered communication issues and taught clinically beneficial communication skills. The identified specific communication deficiencies will direct future curriculum goals. The SBAR model is an effective and valuable tool to standardize communication. Early outcomes analysis demonstrates a decrease in order entry errors after training. Sentinel events are infrequent and will require long-term evaluation.

Entities:  

Mesh:

Year:  2011        PMID: 21242451     DOI: 10.1001/archsurg.2010.294

Source DB:  PubMed          Journal:  Arch Surg        ISSN: 0004-0010


  15 in total

1.  Leveraging Telemedicine Infrastructure to Monitor Quality of Operating Room to Intensive Care Unit Handoffs.

Authors:  Mark E Barry; Beth R Hochman; Meghan B Lane-Fall; Denise Zappile; Daniel N Holena; Brian P Smith; Lewis J Kaplan; Ann Huffenberger; Patrick M Reilly; Jose L Pascual
Journal:  Acad Med       Date:  2017-07       Impact factor: 6.893

2.  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

Review 3.  [Structured patient handovers in perioperative medicine : Rationale and implementation in clinical practice].

Authors:  M J Merkel; V von Dossow; B Zwißler
Journal:  Anaesthesist       Date:  2017-06       Impact factor: 1.041

4.  A qualitative analysis of acute care surgery in the United States: it's more than just "a competent surgeon with a sharp knife and a willing attitude".

Authors:  Heena P Santry; Patricia L Pringle; Courtney E Collins; Catarina I Kiefe
Journal:  Surgery       Date:  2013-12-16       Impact factor: 3.982

5.  Utilization of morning report by acute care surgery teams: results from a qualitative study.

Authors:  Patricia L Pringle; Courtney Collins; Heena P Santry
Journal:  Am J Surg       Date:  2013-11       Impact factor: 2.565

6.  Patient communication during handovers between emergency medicine and internal medicine residents.

Authors:  Miriam Fischer; Robin R Hemphill; Eva Rimler; Stephanie Marshall; Erica Brownfield; Philip Shayne; Lorenzo Di Francesco; Sally A Santen
Journal:  J Grad Med Educ       Date:  2012-12

7.  Handoff quality for obstetrical inpatients varies depending on time of day and provider type.

Authors:  Sarah L Goff; Alexander Knee; Michelle Morello; Daniel Grow; Fadi Bsat
Journal:  J Reprod Med       Date:  2014 Mar-Apr       Impact factor: 0.142

8.  Patient safety in surgical oncology: perspective from the operating room.

Authors:  Yue-Yung Hu; Caprice C Greenberg
Journal:  Surg Oncol Clin N Am       Date:  2012-07       Impact factor: 3.495

Review 9.  A handoff is not a telegram: an understanding of the patient is co-constructed.

Authors:  Michael D Cohen; Brian Hilligoss; André Carlos Kajdacsy-Balla Amaral
Journal:  Crit Care       Date:  2012-02-08       Impact factor: 9.097

10.  SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study.

Authors:  Maria Randmaa; Gunilla Mårtensson; Christine Leo Swenne; Maria Engström
Journal:  BMJ Open       Date:  2014-01-21       Impact factor: 2.692

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