Resident views toward sign-out are diverse, and accuracy of written records may be limited. Consecutive sign-outs are associated with degradation of information. An appreciative-inquiry approach capitalizing on exemplar residents was effective at creating standards for sign-out.

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Physician handoff of care is a mechanism for transferring patient information, responsibility, and authority from one set of caregivers to another. At shift change at a hospital, residents going off shift handoff patients to those coming on shift. There are limited handoff of care tools that facilitate the handover process by condensing patient information in reports that can be referenced during the handoff of care and used during patient care as cognitive artifacts. This effort works to address information, data entry and reporting requirements for a resident handoff of care tool that would support transfer of information as well as patient care.

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