Background:
Medical errors commonly occur during patient handoffs. Discontinuous care results in medical complications, redundant testing, and prolonged hospital stays. Teaching of handoffs is underemphasized in most residency training programs, and few supervising physicians are formally trained in handoffs. We sought to educate internal medicine attending physicians about the importance of handoffs and the verbal and written handoff structures advocated in our training program as well as to encourage them to teach and supervise these handoff processes to their interns.
Methods:
Internal medicine attendings at 4 University of Colorado teaching hospitals completed a survey at the beginning of each month assessing attitudes regarding the importance of handoffs, prior formal handoff training, knowledge of handoff structure, and current involvement teaching formal handoff strategies to house staff. Attending physicians participated in a 30‐minute interactive, small‐group session on handoffs developed and taught by the authors. A survey was administered after the session to assess its utility and the subsequent knowledge and attitudes about handoffs gained by the attendings. They were then asked to observe their interns' handoffs and evaluate performance using a standardized evaluation tool. At the end of the month, attendings completed a survey reassessing their attitudes about handoffs, their perceptions of the utility of teaching and evaluating their interns' handoffs, and their knowledge of the recommended handoff structure.
Results:
Twenty‐six faculty members participated. Faculty participants had mean of 9.4 ± 10.2 years of teaching experience. Ten (31%) and 1 (4%) had received formal instruction about handoffs during residency and medical school, respectively. Although 100% of participants agreed that handoffs have become more important in academic medical centers since duty hour limitations, 40% “rarely” or “never” taught handoffs, 76% “rarely” or “never” observed handoffs, and 84% “rarely” or “never” supervised handoffs. The educational intervention increased the proportion of faculty who knew our locally recommended structure for written and verbal handoffs from 12% to 100% (P < 0.0001). All faculty members believed the training was “useful” or “extremely useful.”
Conclusions:
University of Colorado internal medicine faculty believe handoffs are increasingly important, but prior to our educational intervention, few taught, observed, or supervised them. The educational intervention was effective in teaching faculty the recommended local structure for written and verbal handoffs and was found to be highly useful. Faculty development measures should be incorporated to ensure that patient handoffs are reliably taught and evaluated by attending faculty at academic medical centers. Future residency program requirements may address the teaching and supervision of handoffs.
Author Disclosure:
E. Chu, none; G. Mlsky, none; M. Anderson, none; J. Manheim, none; M, Reid, none; R. Albert, none.