Use of an Appreciative Inquiry Approach to Improve Resident Sign-Out in an Era of Multiple Shift Changes

Helms, Adam S.; Perez, Thomas E.; Baltz, Joseph; Donowitz, Gerald R.; Hoke, George; Bass, Ellen J.; Plews-Ogan, Margaret

doi:10.1007/s11606-011-1885-4

Cited by 37 publications

(36 citation statements)

References 14 publications

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“…Students confi rmed that they were optimistic about the future and, faced with the possibility of working in teams with collaborative practices between workers with diff erent backgrounds (20) , which is in line with the results of this study, where it was identifi ed that residents value and realize the importance of teamwork, combined with the pleasure provided by integration in multidisciplinary work.…”

Section: Today We Do Not Work Much In the Professional Core It' S Mosupporting

confidence: 85%

Suffering and pleasure in the process of forming multidisciplinary health residents

Fernandes

Beck

Weiller

et al. 2015

Rev. Gaúcha Enferm.

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Objective: to identify situations of pleasure and suffering in the process of training multidisciplinary health resident. Method: qualitative research, developed in the Multiprofessional Residence Program in Health at a university from the south of Brazil. Data was collected in 2013 through focus groups with nine residents, and analyzed according to a thematic analysis. Results: The situations of suffering were stimulated by negative situations undergone by the health workers such as difficulties in participating in other professional training activities, excessive number of activities the residents commit to as health workers, lack of knowledge and hindered integration in the areas of Residency. The situations of pleasure were a result of the multiprofessional activities developed and the resident's larning possibility. Conclusion: The situations of pleasure and suffering identified can help in the planning of institutional actions that contribute to a professional training process and the overall wellbeing of the residents.

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Section: Today We Do Not Work Much In the Professional Core It' S Mosupporting

confidence: 85%

Suffering and pleasure in the process of forming multidisciplinary health residents

Fernandes

Beck

Weiller

et al. 2015

Rev. Gaúcha Enferm.

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“…16,17 Moreover, methods such as appreciative inquiry can help identify the peers with the best practices to emulate. 18 Future efforts to validate peer assessment of handoffs against these other assessment methods, such as direct observation by service attendings, are needed.…”

Section: Discussionmentioning

confidence: 99%

Implementing Peer Evaluation of Handoffs: Associations With Experience and Workload

Arora

Greenstein

Woodruff

et al. 2013

Journal of Hospital Medicine

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BACKGROUND Although peer evaluation can be used to evaluate in‐hospital handoffs, few studies have described using this strategy. OBJECTIVE Our objective was to assess feasibility of an online peer handoff evaluation and characterize performance over time among medical interns. DESIGN The design was a prospective cohort study. PATIENTS Subjects were medical interns from residency program rotating at 2 teaching hospitals. MEASUREMENTS Measurements were performance on an end‐of‐rotation evaluation of giving and receiving handoffs. RESULTS From July 2009 to March 2010, 31 interns completed 60% (172/288) of peer evaluations. Ratings were high across domains (mean, 8.3–8.6). In multivariate regression controlling for evaluator and evaluatee, statistically significant improvements over time were observed for 4 items compared to the first 3 months of the year: 1) communication skills (season 2, +0.34 [95% confidence interval (CI), 0.08‐0.60], P = 0.009); 2) listening behavior (season 2, +0.29 [95% CI, 0.04‐0.55], P = 0.025); 3) accepting professional responsibility (season 3, +0.37 [95% CI, 0.08‐0.65], P = 0.012); and 4) accessing the system (season 2, +0.21 [95% CI, 0.03‐0.39], P = 0.023). Ratings were also significantly lower when interns were postcall in written sign‐out quality (8.21 vs 8.39, P = 0.008) and accepting feedback (8.25 vs 8.42, P = 0.006). Ratings from a community hospital rotation, with a lower census than the teaching hospital, were significantly higher for overall performance and 7 of 12 domains (P < 0.05 for all). Significant evaluator effects were observed. CONCLUSIONS Although there is evidence of leniency, peer evaluation of handoffs demonstrate increases over time and associations with workload such as postcall status. This suggests the importance of examining how workload impacts handoffs in the future. Journal of Hospital Medicine 2013;8:132–136. © 2012 Society of Hospital Medicine

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“…6 A recent, appreciative-inquiry study 7 in a large internal medicine training program found that handoffs varied widely in the absence of an educational curriculum and that a consistent methodology for sign-out organization is key.…”

Section: What Is Knownmentioning

confidence: 99%

Improving Written Sign-Outs Through Education and Structured Audit: The UPDATED Approach

DeKosky¹,

Gangopadhyaya²,

Chan³

et al. 2013

Journal of Graduate Medical Education

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The Accreditation Council for Graduate Medical Education Common Program Requirements mandate that all residency programs need to monitor and ensure resident competency in patient handoffs.1 Changes in resident duty hours have increased the volume and complexity of handoffs and have increased the use of ''bridge'' or ''float'' residents who may not have prior knowledge of the patients. Ensuring proper creation and maintenance of the written sign-out is critical in this environment. Existing curricula to teach sign-out communication to residents have focused almost exclusively on verbal handoffs.2 Tools to facilitate teaching, monitoring, and evaluation of written sign-outs are especially lacking. This becomes even more important given the focus on educational milestones related to written communication, such as providing ''legible, accurate, complete, and timely written communication that is congruent with medical standards. '' 3 What Is KnownStudies suggest that written sign-outs are often plagued by medication errors, including omissions and erroneous information. Often, these errors result from failure to keep the sign-out updated. 4 Although the growing adoption of electronic health records can streamline documentation through linking data to sign-out applications, cut and paste problems and information overload may still occur. 5Ensuring proper creation and maintenance of the written sign-out is critical in today's environment.Structured templates for documenting handoff information are recommended by professional organizations. 6A recent, appreciative-inquiry study 7 in a large internal medicine training program found that handoffs varied widely in the absence of an educational curriculum and that a consistent methodology for sign-out organization is key.One promising technique for teaching written sign-outs is the use of practice audits, which can promote reflection on past performance and facilitate transfer of knowledge into actual clinical practice. 8The UPDATED ApproachThe UPDATED educational approach to teaching written sign-outs emphasizes the importance of the following attributes of sign-outs:Updated administrative data

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Use of an Appreciative Inquiry Approach to Improve Resident Sign-Out in an Era of Multiple Shift Changes

Abstract: 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.

Cited by 37 publications

References 14 publications

Suffering and pleasure in the process of forming multidisciplinary health residents

Suffering and pleasure in the process of forming multidisciplinary health residents

Implementing Peer Evaluation of Handoffs: Associations With Experience and Workload

Improving Written Sign-Outs Through Education and Structured Audit: The UPDATED Approach

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