• 1

    Vidyarthi AR, Arora V, Schnipper JL, et al: Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-out. J Hosp Med 1: 257, 2006.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Greenstein EA, Arora VM, Staisiunas PG, et al: Characterising physician listening behaviour during hospitalist handoffs using the HEAR checklist. BMJ Qual Saf 22: 203, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Arora VM, Manjarrez E, Dressler DD, et al: Hospitalist handoffs: a systematic review and task force recommendations. J Hosp Med 4: 433, 2009.

  • 4

    Vidyarthi AR: AHRQ cases and commentaries: triple handoff. Available at: https://psnet.ahrq.gov/webmm/case/134. Accessed May 19, 2016.

  • 5

    Nagpal K, Abboudi M, Manchanda C, et al: Improving postoperative handover: a prospective observational study. Am J Surg 206: 494, 2013.

  • 6

    Pringle LP, Collins C, Santry HP: Utilization of morning report by acute care surgery teams: results from a qualitative study. Am J Surg 206: 647, 2013.

  • 7

    Nasca TJ, Weiss KB, Bagian JP: Improving clinical learning environments for tomorrow's physicians. N Engl J Med 370: 991, 2014.

  • 8

    Kitch BT, Cooper JB, Zapol WM, et al: Handoffs causing patient harm: a survey of medical and surgical house staff. Jt Comm J Qual Patient Saf 34: 563, 2008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Cohen MD, Hilligoss PB: The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care 19: 493, 2010.

    • Search Google Scholar
    • Export Citation
  • 10

    Gephart SM: The art of effective handoffs: what is the evidence? Adv Neonatal Care 12: 37, 2012.

  • 11

    Jensen AM, Sanders C, Doty J, et al: Characterizing information decay in patient handoffs. J Surg Educ 71: 480, 2014.

  • 12

    Abraham J, Kannampallil TG, Almoosa KF, et al: Comparative evaluation of the content and structure of communication using two handoff tools: implications for patient safety. J Crit Care 29: e1, 2014.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13

    Abraham J, Kannampallil TG, Patel VL: Bridging gaps in handoffs: a continuity of care based approach. J Biomed Inform 45: 240, 2012.

  • 14

    Friesen MA, White SV, Byers JF: Handoffs: implications for nurses. Available at: http://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/FriesenM_HOIN.pdf. Accessed May 19, 2016.

    • Search Google Scholar
    • Export Citation
  • 15

    The Joint Commission. Transitions of care: the need for a more effective approach to continuing patient care. Available at: https://www.jointcommission.org/hot_topics_toc/. Accessed May 19, 2016.

    • Search Google Scholar
    • Export Citation
  • 16

    Streitenberger K, Breen-Reid K, Harris C: Handoffs in care: can we make them safer? Pediatr Clin North Am 53: 1185, 2006.

  • 17

    Riesenberg LA, Leitzsch J, Massucci JL, et al: Residents' and attending physicians' handoffs: a systematic review of the literature. Acad Med 84: 1775, 2009.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Solet DJ, Norvell JM, Rutan GH, et al: Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med 80: 1094, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    American Board of Medical Specialties. Based on core competencies. Available at: http://www.abms.org/board-certification/a-trusted-credential/based-on-core-competencies/. Accessed May 19, 2016.

    • Search Google Scholar
    • Export Citation
  • 20

    Sawatsky AP, Mikhael JR, Punatar AD, et al: The effects of deliberate practice and feedback to teach standardized handoff communication on the knowledge, attitudes, and practices of first-year residents. Teach Learn Med 25: 279, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Accreditation Council for Graduate Medical Education: CLER pathways to excellence: expectations for an optimal clinical learning environment to achieve safe and high quality patient care. Available at: http://www.acgme.org/Portals/0/PDFs/CLERBrochure.pdf. Accessed September 5, 2016.

    • Search Google Scholar
    • Export Citation
  • 22

    American Medical Association: The GME Competency Education Program. Available at: http://www.ama-assn.org/ama/pub/education-careers/graduate-medical-education/introduction-to-practice-medicine.page? Accessed September 5, 2016.

    • Search Google Scholar
    • Export Citation
  • 23

    Council on Podiatric Medical Education: CPME 320: Standards and requirements for approval of podiatric medicine and surgery residencies. Available at: http://www.cpme.org/residencies/content.cfm?ItemNumber=2444. Accessed May 19, 2016.

    • Search Google Scholar
    • Export Citation
  • 24

    Mistry KP, Jaggers J, Lodge AJ, et al: “Using Six Sigma® Methodology to Improve Handoff Communication in High-Risk Patients,” in Advances in Patient Safety: New Directions and Alternative Approaches, edited by K Henriksen, JB Battles, MA Keyes, et al, Agency for Healthcare Research and Quality, Rockville, MD, 2008. Vol 3: Performance and Tools. Available at: https://www.ncbi.nlm.nih.gov/books/NBK43658/. Accessed January 29, 2018.

    • Search Google Scholar
    • Export Citation
  • 25

    Catchpole KR, de Leval MR, McEwan A, et al: Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality. Pediatr Anaesth 17: 470, 2007.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26

    Khandelwal C, Mizell J, Steliga M, et al: Standardizing the culture of trauma rotation handoffs. J Surg Educ 71: 601, 2014.

  • 27

    Streitenberger K, Breen-Reid K, Harris C: Handoffs in care: can we make them safer? Pediatr Clin North Am 53: 1185, 2006.

  • 28

    Birmingham P, Buffum MD, Blegen MA, et al: Handoffs and patient safety: grasping the story and painting a full picture. West J Nurs Res 37: 1458, 2015.

  • 29

    Raval MV, Rust L, Thakkar RK, et al: Development and implementation of an electronic record generated surgical handoff and rounding tool. J Med Syst 39: 8, 2015.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Van Eaton EG, Horvath KD, Lober WB, et al: A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours. J Am Coll Surg 200: 538, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Starmer AJ, Spector ND, Srivastava R, et al;for the I-PASS Study Group: Changes in medical errors after implementation of a handoff program. N Engl J Med 371: 1803, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Starmer AJ, Spector ND, Srivastava R, et al;I-PASS Study Group: I-PASS, a mnemonic to standardize verbal handoffs. Pediatrics 129: 201, 2012.

A Survey of Patient Care Handoff and Sign-Out Practices Among Podiatric Surgical Residency Programs

Laura E. Sansosti Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.

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Amanda Crowell Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.

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Whitney Ellis-McConnell Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.

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Andrew J. Meyr Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.
Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Background:

A patient “handoff,” or the “sign-out” process, is an episode during which the responsibility of a patient transitions from one health-care provider to another. These are important events that affect patient safety, particularly because a significant proportion of adverse events have been associated with a relative lack of physician communication. The objective of this investigation was to survey podiatric surgical residency programs with respect to patient care handoff and sign-out practices.

Methods:

A survey was initially developed and subsequently administered to the chief residents of 40 Council on Podiatric Medical Education–approved podiatric surgical residency programs attempting to elucidate patient care handoff protocols and procedures and on-call practices.

Results:

Although it was most common for patient care handoffs to occur in person (60.0%), programs also reported that handoffs regularly occurred by telephone (52.5%) and with no direct personal communication whatsoever other than the electronic passing of information (50.0%). In fact, 27.5% of programs reported that their most common means of patient care handoff was without direct resident communication and was instead purely electronic. We observed that few residents reported receiving formal education or assessment/feedback (17.5%) regarding their handoff proficiency, and only 5.0% of programs reported that attending physicians regularly took part in the handoff/sign-out process. Although most programs felt that their sign-out practices were safe and effective, 67.5% also believed that their process could be improved.

Conclusions:

These results provide unique information on a potentially underappreciated aspect of podiatric medical education and might point to some common deficiencies regarding the development of interprofessional communication within our profession during residency training.

Corresponding author: Andrew J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 8th at Race Street, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)