Residency

Strategies for patient handoffs vary, study shows

Residency Program Insider, September 8, 2009

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One concern regarding further limits to resident work hours is the increase of patient hand-offs.

ACGME’s senior vice president for field activities, Ingrid Philibert, PhD, MBA, recently looked at factors that impact the accuracy of handoffs, including data summaries and end-of-shift transfer strategies. Data was gathered from qualitative interviews and surveys completed by internal medicine, surgery, pediatric, and OB/GYN residents.

Philibert found that the nature of residents’ work varied. Residents cared for many patients with different needs that resulted in different handoff approaches. Additionally, residents’ clinical skill levels affected the accuracy of the handoff.  Cross-coverage and more duty hour limits adversely affected hand-off accuracy.

Philibert concluded that because the data showed the quality of handoffs depend on resident skill, there may be a need for education and supervision when junior residents are involved in handoffs. She also calls for more studies looking at how to conduct handoffs during shortened resident shifts.

The study, Use of strategies from high-reliability organisations to the patient hand-off by resident physicians: Practical implications, appeared in the Aug. issue of the journal, Quality and Safety in Health Care.



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