Dataset Information

Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents.

ABSTRACT:

Background

The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review program requires residents to receive training in handoffs, but there is limited information on best practices in implementing handoff training.

Objective

We hypothesized that a bundled, standardized approach to handoffs during intern orientation would increase trainee comfort, confidence, and knowledge.

Methods

All incoming internal medicine interns participated in a Care Transitions workshop during orientation that was divided into 3 sections: introduction and handoff videos using the I-PASS handoff tool, small group discussion of case scenarios, and a 1-on-1 handoff simulation with an evaluator. Participants completed pre- and postworkshop surveys. We reviewed handoff documents to assess whether residents continued to report illness severity-a key component of I-PASS-after the intervention.

Results

Over 3 years, 225 of 229 (98%) interns completed the preworkshop survey, and 191 (83%) completed the postworkshop survey. Between 2014 and 2016, the number of incoming interns reporting prior training in handoffs during medical school increased from 45% to 63%. Interns' self-reported comfort with providing effective handoffs and self-reported confidence identifying factors essential to an effective verbal handoff (measured on a 5-point Likert scale) improved significantly after the intervention (P < .05 for all questions and years). During 1 year, written handoffs for 28?498 patients were analyzed, and I-PASS illness severity was documented 99.4% of the time.

Conclusions

The Care Transitions workshop consistently improved comfort, confidence, and knowledge of interns in performing handoffs and resulted in sustained change in handoff documentation.

SUBMITTER: Lescinskas E

PROVIDER: S-EPMC6314362 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents.

Lescinskas Erica E Stewart Diana D Shah Chirayu C

Journal of graduate medical education 20181201 6

<h4>Background</h4>The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review program requires residents to receive training in handoffs, but there is limited information on best practices in implementing handoff training.<h4>Objective</h4>We hypothesized that a bundled, standardized approach to handoffs during intern orientation would increase trainee comfort, confidence, and knowledge.<h4>Methods</h4>All incoming internal medicine interns participated in a Ca ...[more]

PMID: 30619532

Similar Datasets

Project description:BackgroundPoor quality handoffs have been identified as a major patient safety issue. In residency programs, problematic handoffs may be an unintended consequence of duty-hour restrictions, and key data are frequently omitted from written handoffs because of the lack of standardization of content.ObjectiveDetermine whether an intervention that facilitates face-to-face communication supported by an electronic template improves the quality and safety of handoffs.DesignBefore-after trial.ParticipantsThirty-nine interns providing nighttime coverage over 132 intern shifts, representing ?9,200 handoffs.InterventionsTwo interventions were implemented serially-an alteration of the shift model to facilitate face-to-face verbal communication between the primary and nighttime covering physicians and an electronic template for the day-to-night handoff.MeasurementsOverall satisfaction and handoff quality were measured using a survey tool administered at the end of each intern shift. Written handoff quality, specifically the documentation of key components, was also assessed before and after the template intervention by study investigators. Interns used the survey tool to report patient safety events related to poor quality handoffs, which were validated by study investigators.ResultsIn adjusted analyses comparing intern cohorts with similar levels of training, overall satisfaction with the new handoff processes improved significantly (p?<?0.001) post intervention. Verbal handoff quality (4/10 measures) and written handoff quality (5/6 measures) also improved significantly. Study investigators also found significant improvement in documentation of key components in the written handoff. Interns reported significantly fewer reported data omissions (p?=?0.001) and a non-significant reduction in near misses (p?=?0.056), but no significant difference in adverse events (p?=?0.41) post intervention.ConclusionsRedesign of shift models common in residency programs to minimize the number of handoffs and facilitate face-to-face communication, along with implementation of electronic handoff templates, improves the quality of handoffs in a learning environment.

Dataset Information

Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents.

Background

Objective

Methods

Results

Conclusions

Publications

Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets