A Model for Building a Standardized Hand-off Protocol

Arora, Vineet M.; Johnson, Julie K.

doi:10.1016/s1553-7250(06)32084-3

Cited by 253 publications

(197 citation statements)

References 9 publications

Supporting

Mentioning

191

Contrasting

Order By: Relevance

“…10,11 The aforementioned research has led to several recommendations for interventions to improve handoffs. 1,2,5,6,[12][13][14] The few published intervention studies have not examined patient safety events as outcomes, leading experts to question the utility of standardization of handoffs as a patient safety initiative. 15 Additionally, despite several studies evaluating written handoff templates and educational workshops, we are not aware of any studies examining the effect of more system-wide interventions to address the problematic shift models that are common in the era of duty hours restrictions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of a Systems Intervention on the Quality and Safety of Patient Handoffs in an Internal Medicine Residency Program

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Poor quality handoffs have been identified as a major patient safety issue. In residency programs, problematic handoffs may be an unintended consequence of duty-hour restrictions, and key data are frequently omitted from written handoffs because of the lack of standardization of content. OBJECTIVE: Determine whether an intervention that facilitates face-to-face communication supported by an electronic template improves the quality and safety of handoffs. DESIGN: Before-after trial. PARTICIPANTS: Thirty-nine interns providing nighttime coverage over 132 intern shifts, representing ∼9,200 handoffs. INTERVENTIONS: Two interventions were implemented serially-an alteration of the shift model to facilitate face-to-face verbal communication between the primary and nighttime covering physicians and an electronic template for the day-to-night handoff. MEASUREMENTS: Overall satisfaction and handoff quality were measured using a survey tool administered at the end of each intern shift. Written handoff quality, specifically the documentation of key components, was also assessed before and after the template intervention by study investigators. Interns used the survey tool to report patient safety events related to poor quality handoffs, which were validated by study investigators. RESULTS: In adjusted analyses comparing intern cohorts with similar levels of training, overall satisfaction with the new handoff processes improved significantly (p<0.001) post intervention. Verbal handoff quality (4/ 10 measures) and written handoff quality (5/6 measures) also improved significantly. Study investigators also found significant improvement in documentation of key components in the written handoff. Interns reported significantly fewer reported data omissions (p=0.001) and a non-significant reduction in near misses (p=0.056), but no significant difference in adverse events (p=0.41) post intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The interventions were based on an extensive review of the handoff literature across numerous industries and an informal survey of handoff recipients at our institution. 1,6,7,9,13,[16][17][18] The interventions were additive, such that the second intervention occurred with the first in place.…”

Section: Study Design and Interventionmentioning

confidence: 99%

Effect of a Systems Intervention on the Quality and Safety of Patient Handoffs in an Internal Medicine Residency Program

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Validity evidence for using the assessment tool include its content, prior response by resident physicians, and use in a variety of health care settings where patient handoffs occur. 5,7,10,[24][25][26] Performance was calculated as the percentage of the total score out of the total possible score. A 40% random sample of audio recordings was rescored by a second rater using the same checklist to assess interrater reliability.…”

Section: What Is Newmentioning

confidence: 99%

“…Examples include templates 10 and mnemonics. 11 Research on patient handoff skill acquisition and retention remains sparse.…”

Section: Introductionmentioning

confidence: 99%

Internal Medicine Postgraduate Training and Assessment of Patient Handoff Skills

Didwania¹,

Kriss²,

Cohen³

et al. 2013

Journal of Graduate Medical Education

View full text Add to dashboard Cite

Background Effective communication during patient care transitions is essential for high-quality patient care. Objective The purpose of this study was (1) to objectively assess patient handoff skills of internal medicine residents, and (2) to evaluate correlations between clinical experience and patient handoff skill self-assessment with directly observed skill. Methods We studied simulated patient handoffs in postgraduate year (PGY)-1 and PGY-2 residents between July 2011 and September 2011, using a standardized scenario in an observed structured handoff exam (OSHE). Our design was a posttest-only, with nonequivalent groups. Assessment used a previously published checklist for evaluating handoff skills. Residents were asked about clinical experience with patient handoffs and about their self-confidence in performing a patient handoff independently. We evaluated between-group differences on OSHE checklist performance, patient handoff experience, and self-confidence and used multiple regression analyses to assess the association between performance, experience, and confidence. Results Forty-seven PGY-1 residents and 38 PGY-2 residents completed the study. Interrater reliability was substantial (intraclass correlation = 0.68). There was no significant difference in OSHE performance by PGY-1 residents (mean = 79%, SD = 4.6) and PGY-2 residents (mean = 82%; SD = 7.6; P = .07). The PGY-2 residents were significantly more experienced (P < .001) and confident (P < .001) than PGY-1 residents were, yet clinical experience and self-confidence did not significantly predict OSHE performance. Conclusions Clinical experience and self-assessment do not predict skills in simulated patient handoffs, and residents with substantial clinical experience still benefit from further skills development.

show abstract

“…[7][8][9][10][11] Communication skills such as active listening, dynamic skepticism, and closed loop communication were emphasized. Environmental factors, such as noise and distraction, and how they influence the handoff process, and ways to mitigate these effects were discussed.…”

Section: Description Of the Workhopmentioning

confidence: 99%

An Interactive Handoff Workshop to Improve Intern Readiness in Patient Care Transitions

Aylward¹,

Vawter²,

Roth³

2012

Journal of Graduate Medical Education

View full text Add to dashboard Cite

Introduction Patient handoffs are common during residency and are often performed with little or no training. We devised a simple intervention to improve the readiness of interns to perform handoffs. Methods We administered a 90-minute interactive workshop during intern orientation in 2009 and 2010. It consisted of a discussion, a case presentation, and a trigger video, followed by debriefing and a role-play exercise. The workshop required minimal technology and materials. Interns were surveyed on their readiness to perform handoffs before and after the workshop as well as 3 to 6 months after the workshop. Results Eighty-nine interns participated in the workshop during a 2-year period. Seventy-four survey responses were collected. Self-reported readiness to perform a handoff increased by 26%. A total of 91% and 81% of respondents in 2010 and 2009, respectively, reported using aspects of the workshop up to 6 months later. Conclusion A brief workshop can improve interns' readiness to perform handoffs.

show abstract

A Model for Building a Standardized Hand-off Protocol

Cited by 253 publications

References 9 publications

Effect of a Systems Intervention on the Quality and Safety of Patient Handoffs in an Internal Medicine Residency Program

Effect of a Systems Intervention on the Quality and Safety of Patient Handoffs in an Internal Medicine Residency Program

Internal Medicine Postgraduate Training and Assessment of Patient Handoff Skills

An Interactive Handoff Workshop to Improve Intern Readiness in Patient Care Transitions

Contact Info

Product

Resources

About