Literature DB >> 24455017

Standardizing and Evaluating Transitions of Care in the Era of Duty Hour Reform: One Institution's Resident-Led Effort.

Joel C Boggan, Tian Zhang, Chris Derienzo, Karen Frush, Kathryn Andolsek.   

Abstract

BACKGROUND: Compliance with the Accreditation Council for Graduate Medical Education duty hour standards may necessitate more frequent transitions of patient responsibility. INTERVENTION: We created a multidisciplinary Patient Safety and Quality Council with a Task Force on Handoffs (TFH), engaging residents at a large, university-based institution.
METHODS: The TFH identified core content of effective handoffs and patterned institutional content on the SIGNOUTT mnemonic. A web-based module highlighting core content was developed for institutional orientation of all trainees beginning summer 2011 to standardize handoff education. The TFH distributed handoff material and catalogued additional program initiatives in teaching and evaluating handoffs. A standard handoff evaluation tool, assessing content, culture, and communication, was developed and "preloaded" into the institution-wide electronic evaluation system to standardize evaluation. The TFH developed questions pertaining to handoffs for an annual institutional survey in 2011 and 2012. Acceptability of efforts was measured by program participation, and feasibility was measured by estimating time and financial costs.
RESULTS: Programs found the TFH's efforts to improve handoffs acceptable; to date, 13 program-specific teaching initiatives have been implemented, and the evaluation tool is being used by 5 programs. Time requirements for TFH participants average 2 to 3 h/mo, and financial costs are minimal. More residents reported having education on handoffs (58% [388 of 668] versus 42% [263 of 625], P < .001) and receiving adequate signouts (69% [469 of 680] versus 61% [384 of 625], P  =  .004) in the 2012 survey, compared with 2011.
CONCLUSIONS: Use of a multispecialty resident leadership group to address content, education, and evaluation of handoffs was feasible and acceptable to most programs at a large, university-based institution.

Entities:  

Year:  2013        PMID: 24455017      PMCID: PMC3886467          DOI: 10.4300/JGME-D-12-00287

Source DB:  PubMed          Journal:  J Grad Med Educ        ISSN: 1949-8357


  21 in total

1.  Using direct observation, formal evaluation, and an interactive curriculum to improve the sign-out practices of internal medicine interns.

Authors:  Bhavna Gakhar; Abby L Spencer
Journal:  Acad Med       Date:  2010-07       Impact factor: 6.893

2.  Experience with faculty supervision of an electronic resident sign-out system.

Authors:  Christopher Nabors; Stephen J Peterson; Wei-Nchih Lee; Arif Mumtaz; Tushar Shah; Sachin Sule; Andrew H Gutwein; Leanne Forman; Etta Eskridge; Eric Wold; Gary W Stallings; Kathleen Kelly Burak; Carol Karmen; Caren F Behar; Christine Carosella; Shick Yu; Kausik Kar; Melissa Gennarelli; Gail Bailey-Wallace; Randy Goldberg; Gary Guo; William H Frishman
Journal:  Am J Med       Date:  2010-04       Impact factor: 4.965

3.  A national survey of obstetric anaesthetic handovers.

Authors:  N Sabir; S M Yentis; A Holdcroft
Journal:  Anaesthesia       Date:  2006-04       Impact factor: 6.955

4.  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

5.  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

6.  Patient handoffs: pediatric resident experiences and lessons learned.

Authors:  Maireade E McSweeney; Jenifer R Lightdale; Robert J Vinci; James Moses
Journal:  Clin Pediatr (Phila)       Date:  2010-09-13       Impact factor: 1.168

7.  Clinical handover incident reporting in one UK general hospital.

Authors:  Cinzia Pezzolesi; Fabrizio Schifano; John Pickles; William Randell; Zakar Hussain; Helen Muir; Soraya Dhillon
Journal:  Int J Qual Health Care       Date:  2010-08-13       Impact factor: 2.038

8.  After-hours complications: evaluation of the predictive accuracy of resident sign-out.

Authors:  Vincent C Scoglietti; Kristin T Collier; Eric L Long; Geary P D Bush; Jason R Chapman; Don K Nakayama
Journal:  Am Surg       Date:  2010-07       Impact factor: 0.688

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.  "HAND ME AN ISOBAR": a pilot study of an evidence-based approach to improving shift-to-shift clinical handover.

Authors:  Kwang C Yee; Ming C Wong; Paul Turner
Journal:  Med J Aust       Date:  2009-06-01       Impact factor: 7.738

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  1 in total

Review 1.  Feedback and Assessment Tools for Handoffs: A Systematic Review.

Authors:  Joshua Davis; Catherine Roach; Cater Elliott; Matthew Mardis; Ellen M Justice; Lee Ann Riesenberg
Journal:  J Grad Med Educ       Date:  2017-02
  1 in total

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