Joel J Gagnier1, Joseph M Derosier2, Joseph D Maratt3, Mark E Hake3, James P Bagian4. 1. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA. 2. Center for Healthcare Engineering & Patient Safety, University of Michigan, Ann Arbor, MI, USA. 3. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA. 4. Center for Healthcare Engineering & Patient Safety, University of Michigan, Ann Arbor, MI, USA Department of Industrial & Operations Engineering, University of Michigan, Ann Arbor, MI, USA.
Abstract
OBJECTIVE: To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. DESIGN: Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. SETTING: Large teaching hospital. PARTICIPANTS: Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). INTERVENTION: A handoff tool for use by orthopaedic residents. MAIN OUTCOME MEASUREMENTS: Adverse events in patients handed off by orthopaedic trauma residents. RESULTS: After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). CONCLUSIONS: Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients.
OBJECTIVE: To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. DESIGN: Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. SETTING: Large teaching hospital. PARTICIPANTS: Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). INTERVENTION: A handoff tool for use by orthopaedic residents. MAIN OUTCOME MEASUREMENTS: Adverse events in patients handed off by orthopaedic trauma residents. RESULTS: After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). CONCLUSIONS: Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients.
Authors: Derek S Stenquist; Caleb M Yeung; Hannah J Szapary; Laura Rossi; Antonia F Chen; Mitchel B Harris Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-09-06