The Computerized Rounding Report: Implementation of a Model System to Support Transitions of Care

Wohlauer, Max V.; Rove, Kyle O.; Pshak, Thomas; Raeburn, Christopher D.; Moore, Ernest E.; Chenoweth, Chad; Srivastava, A. K.; Pell, Jonathan; Meacham, Randall B.; Nehler, Mark R.

doi:10.1016/j.jss.2011.04.015

Cited by 30 publications

(26 citation statements)

References 20 publications

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“…Most studies that provided self-reported data on time devoted to activities related to handoffs showed reductions in time allocated to handoffs. 23,27,31,34,39,42 In contrast, in 1 study respondents self-reported a decrease in time devoted to handoff preparation and an increase in the amount of time needed to update handoff information. 32 Another study found conflicting results, with 37% of respondents reporting the electronic system was faster, and 57% reporting the card-based system (control) was faster to use.…”

Section: Self-reported Measuresmentioning

confidence: 72%

“…'' 27 In 1 study, 70% of residents reported that the electronic handoff system helped them adhere to the 80-hour work week. 34 In another, respondents reported an increased ease in adherence with the 80-hour work week from 28% preimplementation to 50% postimplementation of an electronic inpatient handoff system. 31 A survey of 39 departments at a pediatric hospital found that only 9 (23.1%) used an electronic handoff system.…”

Section: Self-reported Measuresmentioning

confidence: 98%

“…38 In 9 studies (24%), perception of patient safety and/or quality of care improved 22,27,31,36,39 ; better patient management 21,25 or fewer near misses 30 were reported; and there was a reduction in missed patients. 34 However, a randomized crossover study found no statistically significant differences in resident-reported unexpected events, medical errors, or adverse drug events when comparing the electronic handoff system to the standard systems used (ie, written lists, card based, or a team-developed spreadsheet), 40 and another study found no difference in reported unexpected events pre-to postimplementation of a new electronic handoff system. 41 Residents responding to a postcall survey reported an unexpected patient event that should have been anticipated during handoff in about onethird of patients in the old as well as the new system.…”

Section: Self-reported Measuresmentioning

confidence: 99%

“…In 22% of the included studies, respondents reported increased or improved handoff content, 22,[29][30][31][32][33][34][35] and 22% of studies also reported high provider satisfaction with use of an electronic handoff system. [22][23][24][25][26][27]31,32 However, in 1 of these studies, 22.6% of respondents reported there was information they did not receive at handoff that would have helped them care for patients.…”

Section: Self-reported Measuresmentioning

confidence: 99%

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Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Davis¹,

Riesenberg²,

Mardis³

et al. 2015

Journal of Graduate Medical Education

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Background Multiple organizations have recognized that handoffs are prone to errors, and there has been an increase in the use of electronic health records and computerized tools in health care. Objective This systematic review evaluates the current evidence on the effectiveness of electronic solutions used to support shift-to-shift handoffs. Methods We searched the English-language literature for research studies published between January 1, 2008, and September 19, 2014, using National Library of Medicine PubMed, EBSCO CINAHL, OvidSP All Journals, and ProQuest PsycINFO. Included studies focused on the evaluation of physician shift-to-shift handoffs and an electronic solution designed to support handoffs. We assessed articles using a quality scoring system, conducted a review of barriers and strategies, and categorized study outcomes into self-report, process, and outcome measures. Results Thirty-seven articles met inclusion criteria, including 20 single group pre- and posttest studies; 8 posttest only or cross-sectional studies; 4 nonrandomized controlled trials; 1 cohort study; 1 randomized crossover study; and 3 qualitative studies. Quality scores ranged from 3.5 to 14 of a possible 16. Most articles documented some positive outcomes, with 2 of the 3 studies evaluating patient outcomes yielding statistically significant improvements. The only other study that analyzed patient outcomes showed that interventions other than the electronic tool were responsible for most of the significant improvements. Conclusions The majority of studies supported using an electronic tool, yet few measured patient outcomes, and numerous studies suffered from methodology issues. Future studies should evaluate patient outcomes, improve study design, assess the role of faculty oversight, and broaden the focus to recognize the role of human factors.

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Section: Self-reported Measuresmentioning

confidence: 72%

Section: Self-reported Measuresmentioning

confidence: 98%

Section: Self-reported Measuresmentioning

confidence: 99%

Section: Self-reported Measuresmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Davis¹,

Riesenberg²,

Mardis³

et al. 2015

Journal of Graduate Medical Education

View full text Add to dashboard Cite

show abstract

“…However, interns often use team-or computer-generated sign-out forms that they do not create themselves. 26,27 Since our focus was on assessing verbal handoff performance, we believe this simulation is an important tool to assess this competency. We lack data on performance in actual clinical settings.…”

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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Influence of Resident Involvement on Trauma Care Outcomes

Bukur¹,

Singer²,

Chung³

et al. 2012

Arch Surg

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The Computerized Rounding Report: Implementation of a Model System to Support Transitions of Care

Cited by 30 publications

References 20 publications

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

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

Influence of Resident Involvement on Trauma Care Outcomes

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