Results of an Enhanced Clinic Handoff and Resident Education on Resident Patient Ownership and Patient Safety

Abstract

Enhancing clinic handoffs can improve the handoff process, increase the likelihood of patients seeing the correct primary care provider within the target time frame, reduce missed tests, and possibly reduce acute visits.

“Ms. B Changes Doctors”: Using a Comic and Patient Transition Packet to Engineer Patient-Oriented Clinic Handoffs (EPOCH)

“…Residents were given suggested criteria to select high-risk patients. 3,9,10 Approximately 30 IM residents per class have clinic at this site, supervised by faculty preceptors, consistent with Accreditation Council for Graduate Medical Education regulations. 14 This study was approved by the University of Chicago Institutional Review Board.…”

“…3,9,10 Departing residents and residents assuming care gave consent for their patients to be contacted to participate in interviews. High-risk patients were contacted by a trained research assistant by telephone and invited to participate during the post-handoff period (October 2011-December 2013).…”

“…5,6 Although several studies in IM have demonstrated improved outcomes with clinic handoff interventions, few have focused on incorporating the patient perspective or assessing patientcentered outcomes to improve care. [7][8][9][10][11] One intervention that educated departing residents on how to discuss the handoff with patients and employed a handoff notification letter increased patient satisfaction. 11 However, several intervention studies were not able to improve missed visits with the new PCP after the handoff, which may be due to patient factors.…”

“…11 However, several intervention studies were not able to improve missed visits with the new PCP after the handoff, which may be due to patient factors. 9,10 The Institute of Medicine and the Agency for Healthcare Research and Quality promote patient-centered care as a means of improving health care quality. 12,13 Thus, incorporating patients' perspectives will be necessary to further improve clinic handoffs and create patient-centered care transitions.…”

Transitions of Care in Continuity Clinic—Lessons Learned and Next Steps

“…These include reducing the variability in the initial outpatient caseload of incoming residents; 6 integrating patient-centered transition information; 7 standardizing templates for electronic, written and verbal sign-out; 8,9 and incorporating a multifaceted approach for transition of high-risk patients. 10,11 Given the high level of medical and social complexity typical of patients seen in resident clinic, targeted interventions aimed at improving care transitions for high-risk patients may be especially relevant.…”