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Teaching handoffs to medical students

Hospitalist Leadership Connection, September 7, 2010

To wish your mother a happy birthday, a note might do, but to propose marriage? Think again. A face-to-face meeting would be more appropriate for the more complex situation.

This analogy is one example of the didactic session, coupled with a practicum, used to teach internal medicine students handoff communication at the University of Colorado, Denver School of Medicine.

Although the Institute of Medicine named patient handoffs as the moment when patient care errors are most likely to occur, only 8% of medical schools specifically teach students how to hand off patients, according to a new study, “Effectiveness of a Course Designed to Teach Handoffs to Medical Students,” published in the July/August Journal of Hospital Medicine.

The Handoff Selective project is aimed at teaching a structured process, using written and verbal templates, formal training, and direct attending supervision to medical students who are transitioning from their third to fourth year.

It emphasizes SAIF-IR, a verbal structure mnemonic device.
Off-going provider performs the following:

• Summary statement(s)
• Active issues
• If-then contingency planning
• Follow-up activities

On-coming provider performs the following:

• Interactive questioning
• Read-backs

The Handoff Selective emphasizes that communicators should focus on the active issues, as well the if-then situations and follow-ups. Study authors also recognize that the most complicated cases often require the most time-consuming communication.

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