Gaining efficiency and satisfaction in the handoff process

Burton, M. Caroline; Kashiwagi, Deanne T.; Kirkland, Lisa L.; Manning, Dennis M.; Varkey, Prathibha

doi:10.1002/jhm.808

Cited by 20 publications

(16 citation statements)

References 17 publications

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“…This same ability, taking pieces of data and applying it to the clinical problem, is also essential to clinical summarization. The students' perception that preparation and review enhanced the handoff experience is also supported in the clinical realm wherein there is evidence that reviewing material prior to receiving a handoff improves the quality of the handoff (Burton et al, ). Together, this suggests that although the students may not recognize the connection, the impact of the anatomic SBAR on students' learning strategies may also help improve their handoff skills within the clinic.…”

Section: Discussionmentioning

confidence: 99%

Practicing handoffs early: Applying a clinical framework in the anatomy laboratory

Lazarus

Santos

Haidet

et al. 2016

Anatomical Sciences Ed

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The anatomy laboratory provides an ideal environment for the integration of clinical contexts as the willed-donor is often regarded as a student's "first patient." This study evaluated an innovative approach to peer teaching in the anatomy laboratory using a clinical handoff context. The authors introduced the "Situation, Background, Assessment, Recommendation" (SBAR) handoff framework within the anatomy laboratory. Study participants included 147 second-year medical students completing the head and neck portion of an anatomy course. The authors used mixed methods to evaluate the impact of the anatomic SBAR on the student anatomy laboratory experience. Qualitative analysis of student evaluations revealed three themes which emerged from students' summaries of their anatomic handoff experiences: Learning-by-teaching; Acquiescing to doing more with less; and Distrust of the peer handoff process. All the themes demonstrated that the anatomic handoff encouraged students' focus on the knowledge preparation and reflection. Closed question analysis suggested that that students' perceptions of handoff usefulness were tied to deeper learning strategies. The handoff provided a mechanism for promoting students' focus on anatomical relationships and facilitated students' learning of transferable clinical skills. Together, these results suggest that the introduction of a handoff process in anatomy education provided both a mechanism for learning anatomy and a unique opportunity for early exposure to an essential clinical skill. This clinical and basic science integration may serve as a vertical integration thread which can be woven throughout undergraduate medical education. Future study will focus on exploring the long-term impacts and learning outcomes of this integration. Anat Sci Educ 9: 476-487. © 2016 American Association of Anatomists.

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Section: Discussionmentioning

confidence: 99%

Practicing handoffs early: Applying a clinical framework in the anatomy laboratory

Lazarus

Santos

Haidet

et al. 2016

Anatomical Sciences Ed

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“…[3][4][5][6][7][8][9] Most recently, researchers have begun to study the impact of year-end handoffs on patient safety in resident ambulatory care practices. Young et al, 7 in a multifaceted intervention in a psychiatric outpatient practice, demonstrated that the categorical designation of patients as 'acute' or 'not acute' by outgoing clinicians effectively identified patients at higher risk for hospitalization during transitions.…”

Section: Introductionmentioning

confidence: 99%

Development of a Structured Year-End Sign-Out Program in an Outpatient Continuity Practice

et al. 2012

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BACKGROUND:In an effort to prevent medical errors, it has been recommended that all healthcare organizations implement a standardized approach to communicating patient information during transitions of care between providers. Most research on these transitions has been conducted in the inpatient setting, with relatively few studies conducted in the outpatient setting. OBJECTIVES: To develop a structured transfer of care program in an academic outpatient continuity practice and evaluate whether this program improved patient safety as measured by the documented completion of patient care tasks at 3 months post-transition. DESIGN: Graduating residents and the corresponding incoming interns inheriting their continuity patient panels were randomized to the pilot structured transfer group or the standard transfer group. The structured transfer group residents were asked to complete written and verbal sign-outs with their interns; the standard transfer group residents continued the current standard of care. PARTICIPANTS: Thirty-two resident-intern pairs in an academic internal medicine residency program in New York City. MAIN MEASURES: Three months after the transition, study investigators evaluated whether patient care tasks assigned by the graduating residents had been successfully completed by the interns in both groups. In addition, follow-up appointments, continuity of care and house officer satisfaction with the sign-out process were evaluated. KEY RESULTS: Among patients seen during the first 3 months, the clinical care tasks were more likely to be completed by interns in the structured group (73 %, n= 49) versus the standard group (46 %, n=28) (adjusted OR 3.21; 95 % CI 1. 55-6.62; p=0.002). This was further enhanced if the intern who saw the patient was also the assigned primary care provider (adjusted OR 4.26; p=0.002). CONCLUSIONS: A structured outpatient sign-out improved the odds of follow-up of important clinical care tasks after the year-end resident clinic transition. Further efforts should be made to improve residents' competency with regard to sign-outs in the ambulatory setting.KEY WORDS: patient safety; transfer of care; handoff; sign-out; continuity of care.

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“…A variety of strategies have been utilized to standardize handoffs. Examples include the use of mnemonics, electronic resources, preformatted handoff sheets, and optimization of the handoff environment . The primary outcomes for many of these studies center on the provider by measuring their retention of patient facts and completion of tasks after handoff, for example.…”

mentioning

confidence: 99%

“…Providers in our division work on 3 shifts: day, evening, and night. In 2009, we developed a face‐to‐face morning handoff, during which night‐shift providers hand off patient care to day‐shift providers incorporating an electronically generated service information list . Given that the evening shift ends well before the day shift begins, the evening‐shift providers do not participate in this face‐to‐face handoff of care for patients they admit to day providers.…”

mentioning

confidence: 99%

Association of face-to-face handoffs and outcomes of hospitalized internal medicine patients

et al. 2015

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BACKGROUND Failures in communication at the time of patient handoff have been implicated as contributing factors to preventable adverse events. OBJECTIVE Examine the relationship between face‐to‐face handoffs and the rate of patient outcomes, including adverse events. DESIGN Retrospective cohort. SETTING A 1157‐bed academic tertiary referral hospital. PATIENTS There were 805 adult patients admitted to general internal medicine services. INTERVENTION Retrospective comparison of clinical outcomes, including the rate of adverse events, of patients whose care was transitioned with and without face‐to‐face handoffs. MEASUREMENTS Rapid response team calls, code team calls, transfers to a higher level of care, death in hospital, 30‐day readmission rate, length of stay, and adverse events (as identified using the Global Trigger Tool). RESULTS There was no significant difference with respect to the frequency of rapid response team calls, code team calls, transfers to a higher level of care, deaths in hospital, length of stay, 30‐day readmission rate, or adverse events between patients whose care was transitioned with or without a face‐to‐face handoff. CONCLUSIONS Face‐to‐face handoff of patients admitted to general medical services at a large academic tertiary referral hospital was not associated with a significant difference in measured patient outcomes, including the rate of adverse events, compared to a non–face‐to‐face handoff. Additional study is needed to determine the qualities of patient handoff that optimize efficiency and safety. Journal of Hospital Medicine 2015;10:137–141. © 2015 Society of Hospital Medicine

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Gaining efficiency and satisfaction in the handoff process

Cited by 20 publications

References 17 publications

Practicing handoffs early: Applying a clinical framework in the anatomy laboratory

Practicing handoffs early: Applying a clinical framework in the anatomy laboratory

Development of a Structured Year-End Sign-Out Program in an Outpatient Continuity Practice

Association of face-to-face handoffs and outcomes of hospitalized internal medicine patients

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