Assessment of Handover Communication among Neurology Residents: Utilization of a Handover OSCE and a Standardized Curriculum To Improve Transitions of Care (P07.237)

Abstract

Objective: Our purpose was to assess changes in handover communication among PGY-2 neurology residents after completing a standardized handover curriculum. Background Handovers between housestaff during transitions of inpatient care are typically unstructured. Handover frequency has increased as a consequence of changes in resident duty hour standards. Omission of key handover information can adversely affect patient safety and outcomes. Formal handover training has not been widely adopted into resident education despite an ACGME mandate that programs ensure and monitor effective, structured handover procedures. Providing formal training in handover procedures achieves the core competencies of enhanced patient care, interpersonal communication, and systems based practice. Design/Methods: A two-part objective structured clinical examination (OSCE) was used to assess handover communication. In Part I, the resident received a verbal handover lacking critical clinical information and was given the opportunity to request additional information from the examiner. In Part II, the resident provided a verbal handover after reading a patient vignette containing both core elements and superfluous information. For each part, a total score of 15 was possible with one point awarded for each of pre-specified15 core elements incorporated by the resident during the simulated handover communication. Following the initial OSCE, residents completed a structured handover curriculum and were re-assessed at 3 months. Results were compared using a paired t -test (GraphPad Software, Inc). Results: Four PGY-2 neurology residents completed the initial and follow-up OSCE. For Part I, the mean initial score was 7.75 and the mean follow-up score was 11.75 (4 point improvement; 95% confidence interval 2.16-5.84, p=0.0062). For Part II, the mean score was 13.25 on both initial and 3-month follow-up assessment. Conclusions: This study suggests that a standardized handover OSCE is sensitive to performance changes after completion of a structured handover curriculum. Standardized education with ongoing resident-to-resident feedback is effective in improving handover competency. Disclosure: Dr. Chiota has nothing to disclose. Dr. McCollum has nothing to disclose. Dr. Mauricio has nothing to disclose. Dr. Ditrapani has nothing to disclose. Dr. Capobianco has nothing to disclose. Dr. Barrett has nothing to disclose.