MedStar Health, Baltimore, MD, and Washington, DC MedStar Health Handoff Initiative

• Published in: The Ochsner journal Vol. 14; no. S; p. 20
• Main Authors: Hafiz, S, Saini, A, Vohra, M, Cross, K, Weisman, D, Williams, R, Detterline, S, Gilbert, J, Remington, J, Emrich, C, Shaver, M, Slowey, J, Ledesma, N
• Format: Journal Article
• Language: English
• Published: New Orleans Ochsner Clinic Foundation Academic Center - Publishing Services 01.03.2014
• ISSN: 1524-5012

Background: The goal of the initiative was to create and implement a comprehensive handoff curriculum across all training programs in accordance with Joint Commission priorities and ACGME requirements for patient safety and continuity of care. This study investigated the current state of resident handoffs throughout MedStar hospitals and the efficacy of a new resident handoff workshop. Methods: The study was conducted at 4 teaching hospitals in MedStar Health. To establish a baseline, an anonymous survey was distributed among residents. Researchers developed a standardized handoff workshop employing the S-T-I-R model (Summary, To Do, If-Then, Readback/Feedback) and offered it to internal medicine, general surgery, and obstetrics/gynecology. Workshop sessions included didactics and simulation with audience interaction. The quality of resident handoffs was evaluated both before and 3–4 months after the workshop by direct observation. Results: Residents from levels PGY1-5 completed 206 preliminary surveys. At baseline, a significant portion of residents across various disciplines lacked handoff protocols (26%) and training (47%); 75% of PGY1 residents said they received no formal training on handoffs in medical school. The postintervention survey was completed by 119 residents. Postworkshop observations found that interns who had received the intervention were significantly more likely to report To Do and If-Then statements, along with facilitating receiver Readback. Conclusions: A handoff workshop led to sustained improvement in handoff quality. Next steps include (1) establishing a handoff workshop with emphasis on the S-T-I-R model at the start of each academic year for all residents and (2) using the handoff checklist to evaluate progress in transitions-of-care milestones and to provide formative feedback on protocol implementation.