Improving Patient Handoffs and Transitions through Adaptation and Implementation of I-PASS Across Multiple Handoff Settings

Abstract Background To date, no standardized presentation format is taught to emergency medicine (EM) residents during patient handoffs to consulting or admitting physicians. The Situation-Background-Assessment-Recommendation (SBAR) is a common format that provides a consistent framework to communicate pertinent information. Objective The objective of this study was to describe and evaluate the feasibility of using SBAR to teach interphysician communication skills to first-year EM residents to use during patient handoffs. Methods An educational study was designed as part of a pilot curriculum to teach first-year EM residents handoff communication skills. A standardized SBAR reporting format was taught during a 1-hour didactic intervention. All residents were evaluated using pretest/posttest simulated cases using a 17-item SBAR checklist initially, and then within 4 months to assess retention of the tool. A survey was distributed to determine resident perceptions of the training and potential clinical utility. Results There was a statistically significant improvement from the resident scores on the pretest/posttest of the first case (P = .001), but there was no difference between posttest of the first case and pretest of the second case (P = .34), suggesting retention of the material. There was a statistically significant improvement from the pretest and posttest scores on the second case (P = .001). The survey yielded good reliability for both sessions (Cronbach alpha = 0.87 and 0.89, respectively), demonstrating statistically significant increases for the perceived quality of training, presentation comfort level, and the use of SBAR (P = .001). Conclusion SBAR was acceptable to first-year EM residents, with improvements in both the ability to apply SBAR to simulated case presentations and retention at a follow-up session. This format was feasible to use as a training method and was well received by our resident physicians. Future research will be useful in examining the general applicability of the SBAR model for interphysician communications in the clinical environment and residency training programs.

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Patient Handoffs:

Why Surgeons Struggle with Work-Hour Reforms ◽

10.2307/j.ctv1dv0w01.6 ◽

2021 ◽

pp. 50-73

Keyword(s):

Patient Handoffs

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An Interactive Handoff Workshop to Improve Intern Readiness in Patient Care Transitions

Journal of Graduate Medical Education ◽

10.4300/jgme-d-11-00067.1 ◽

2012 ◽

Vol 4 (1) ◽

pp. 68-71 ◽

Cited By ~ 3

Author(s):

Michael Aylward ◽

Lemuel Vawter ◽

Craig Roth

Keyword(s):

Patient Care ◽

Role Play ◽

Care Transitions ◽

Case Presentation ◽

Patient Handoffs ◽

Before And After ◽

Interactive Workshop ◽

Survey Responses

Abstract Introduction Patient handoffs are common during residency and are often performed with little or no training. We devised a simple intervention to improve the readiness of interns to perform handoffs. Methods We administered a 90-minute interactive workshop during intern orientation in 2009 and 2010. It consisted of a discussion, a case presentation, and a trigger video, followed by debriefing and a role-play exercise. The workshop required minimal technology and materials. Interns were surveyed on their readiness to perform handoffs before and after the workshop as well as 3 to 6 months after the workshop. Results Eighty-nine interns participated in the workshop during a 2-year period. Seventy-four survey responses were collected. Self-reported readiness to perform a handoff increased by 26%. A total of 91% and 81% of respondents in 2010 and 2009, respectively, reported using aspects of the workshop up to 6 months later. Conclusion A brief workshop can improve interns' readiness to perform handoffs.

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