J. Sugrue1, A. Ejaz1, S. Eftaiha1, H. Shah1, J. Nordenstam1, A. Mellgren1, G. Havelka1 1University Of Illinois At Chicago,Surgery,Chicago, IL, USA
Introduction:
Increasing patient handoffs among surgical residents due to duty hour restrictions have been linked to discontinuity in patient care and potentially worse patient outcomes. Educational interventions designed to evaluate and improve handoffs, however, are lacking. The aim of the current study was to assess resident attitudes towards patient handoffs and to evaluate the impact of resident education on patient handoffs.
Methods:
All 39 general surgery residents at a single academic institution were administered a voluntary survey regarding their attitudes about patient handoffs. Two months after the initial survey, a supplemental voluntary educational course was administered. The course reviewed published literature regarding patient handoffs and provided suggestions to improve the handoff process. One month after the course, the survey was re-administered. In the survey, patient harm was considered minor when there were limited clinical consequences and major when there were significant clinical consequences.
Results:
31 residents (response rate: 79%) completed the initial survey. The majority of residents spent an average of one minute or less on handoffs per patient (n=17, 55%). 90% of residents stated they received an inadequate handoff resulting in minor (n=28, 90%) or major (n=15, 48%) patient harm within the past 12 months. The most common reasons for inadequate handoffs were lack of information in the verbal handoff (57%), lack of information in the written handoff (43%), interruption during the handoff process (26%), and time constraint affecting the incoming resident (26%). Overall, 20 residents (48%) responded that they had been educated on patient handoffs within the past 12 months, including 11 residents (response rate: 28%) who completed the follow-up survey after attendance of the educational course. Resident education reduced the incidence of inadequate handoffs that resulted in minor harm to a patient (p=0.05), and major harm (p=0.13) (Figure 1).
Conclusions:
Nearly all residents received a patient handoff resulting in minor or major patient harm. Resident education reduced the incidence of inadequate handoffs that resulted in patient harm. Further studies are needed to better characterize the optimal manner with which to educate residents on handoffs and to validate instruments to assess the quality of patient handoffs.
