A Structured Handoff Program for Interns

Chu, Eugene S.; Reid, Mark; Schulz, Tara; Burden, Marisha; Mancini, Diana; Ambardekar, Amrut V.; Keniston, Angela; Albert, Richard K.

doi:10.1097/acm.0b013e3181970829

Cited by 72 publications

(56 citation statements)

References 10 publications

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“…While several methods of teaching and evaluating handoffs have been previously described in the literature, 16,19,20,24,25 this study is the first to utilize a multi-patient, simulation-based assessment targeting incoming residents. Our results suggest that this may be a promising strategy to provide continuity in handoff training during the transition from undergraduate to graduate medical education and to identify incoming residents in need of additional practice.…”

Section: Discussionmentioning

confidence: 99%

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

et al. 2016

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BACKGROUND: Despite the identification of transfer of patient responsibility as a Core Entrustable Professional Activity for Entering Residency, rigorous methods to evaluate incoming residents' ability to give a verbal handoff of multiple patients are lacking. AIM: Our purpose was to implement a multi-patient, simulation-based curriculum to assess verbal handoff performance. SETTING: Graduate Medical Education (GME) orientation at an urban, academic medical center. PARTICIPANTS: Eighty-four incoming residents from four residency programs participated in the study. PROGRAM DESCRIPTION: The curriculum featured an online training module and a multi-patient observed simulated handoff experience (M-OSHE). Participants verbally Bhanded off^three mock patients of varying acuity and were evaluated by a trained Breceiver^using an expertinformed, five-item checklist. PROGRAM EVALUATION: Prior handoff experience in medical school was associated with higher checklist scores (23 % none vs. 33 % either third OR fourth year vs. 58 % third AND fourth year, p = 0.021). Prior training was associated with prioritization of patients based on acuity (12 % no training vs. 38 % prior training, p = 0.014). All participants agreed that the M-OSHE realistically portrayed a clinical setting. CONCLUSIONS: The M-OSHE is a promising strategy for teaching and evaluating entering residents' ability to give verbal handoffs of multiple patients. Prior training and more handoff experience was associated with higher performance, which suggests that additional handoff training in medical school may be of benefit.KEY WORDS: medical education; medical student and residency education; communication skills.

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Section: Discussionmentioning

confidence: 99%

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

et al. 2016

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“…With the exception of 1 study, handoff education studies have measured subjective curriculum effectiveness (ie, trainee comfort; self-assessed skills). [11][12][13] Using a randomized design, our pilot suggests that a handoff skills educational intervention can improve the quality of intern's verbal handoff skills and reduce the frequency of certain communication failures. Improved intervention group performance begins to provide support for consequence validity of HET assessments.…”

Section: Discussionmentioning

confidence: 99%

Effects of Education on Interns' Verbal and Electronic Handoff Documentation Skills

Airan-Javia¹,

Kogan²,

Smith³

et al. 2012

Journal of Graduate Medical Education

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Communication errors can cause preventable health care adverse events. Some of these errors occur when physicians handoff their patients' care.1 Resident duty hour limitations have fragmented inpatient care and increased handoff frequency.2 Communication failures during handoffs are well described, with lack of standardization and inadequate training in handoff skills having been implicated as contributing factors.3,4 The Institute of Medicine 5 has responded by recommending resident training in handoff communications. Therefore, developing ways to teach and improve resident handoff quality is a goal for educators.Although various strategies to improve handoff quality have been described, 6 relatively few studies have tested whether teaching residents handoff skills improves handoff quality.7 Our primary aim was to determine the effectiveness of handoff education on the quality of interns' electronic and verbal handoffs by comparing the handoff quality of interns who received education to those who did not. Secondary outcomes included communication failures reported by handoff receivers, environmental handoff behaviors, and changes in interns' knowledge and attitudes regarding handoffs. AbstractBackground Improving handoff communications is a National Patient Safety Goal. Interns and residents are rarely taught how to safely handoff their patients. Our objective was to determine whether teaching safe handoff principles would improve handoff quality.

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“…[4][5][6][7] Vidyarthi described the handoff process as ''traditionally informal, unstructured, and idiosyncratic,'' 4 and many believe efforts to formalize and structure this process are important for patient safety. 8 Standardized handoff forms have improved accuracy of information. 9 Web-based signout systems reportedly reduced the number of patients missed on rounds.…”

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confidence: 99%

Gaining efficiency and satisfaction in the handoff process

Burton

Kashiwagi

Kirkland

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Handoffs, or transfers of patient care responsibility, occur frequently on hospitalist teams. The reliability and efficiency of the handoff process is a national and local concern. Most studies in the literature regard physicians‐in‐training. We studied the morning handoff process of hospitalist teams comprised of staff physicians and nurse practitioner and/or physician assistants.METHODS:An improvement team observed morning handoffs. Four problems were identified: unpredictable start and finish times, inefficiency, poor environment (hallway noise and distracting in‐room conversations), and poor communication. The team restructured the process and observed post‐intervention behavior at 15 and 90 days. A participant‐provider survey was conducted before and after the intervention regarding wasted time, total time‐in‐report, and satisfaction with the process.RESULTS:Pre‐intervention 60.5% of providers (23/38) believed morning handoff was performed in a timely fashion compared to 100% (15/15) post‐intervention (P = 0.005). Average time spent in morning report was 11 minutes, compared to 5 minutes after the intervention (P < 0.0028). Pre‐intervention 6.5 minutes were believed wasteful, compared to 0.5 minutes post‐intervention (P < 0.0001).CONCLUSIONS:This study identifies deficiencies in the handoff process that were addressed by enhancing the physical environment (smaller room, noise reduction, closed door), assigned seating (visual cues by table tent cards), non‐clinicians providing printed materials, standardization of written updates, team times (consistent & precise daily time for each team report), culture change including deference of attention to team receiving report with opportunity for questions, and minimization of side conversations. This intervention package resulted in an improvement in satisfaction and timeliness of clinicians involved. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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A Structured Handoff Program for Interns

Cited by 72 publications

References 10 publications

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

Effects of Education on Interns' Verbal and Electronic Handoff Documentation Skills

Gaining efficiency and satisfaction in the handoff process

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