Abstract
The 80-hour per week work limit resulted in an increased number of patient handoffs. A satisfactory handoff system should optimize the exchange of vital patient information while concisely minimizing error. This project describes our experience and lessons learned in successfully developing and implementing an Electronic Health Record (EHR)-integrated handoff system based on the I-PASS model. The handoff system, termed Physician Handoff, was refined through end-user feedback. End-users were evaluated on the quality of handoff in the following categories: Illness Severity, Patient Summary, Action List, and Situational Awareness. Resulting survey showed high adoption and satisfaction rate with Physician Handoff. Success can be attributed to interdepartmental collaboration, credentialing the users, and recognizing the importance of end-user feedback.
Highlights
A patient would be handed off 15 times over a five-day hospital course [4]
The purpose of this paper is to describe our experience and the lessons we have learned in designing a satisfactory handoff system for resident physicians in our hospital
Developing, implementing, and evaluating an efficient Electronic Health Record (EHR)-integrated handoff system was a momentous undertaking for all individuals involved (IM leadership, Information Technology (IT) department, and the resident physicians)
Summary
No matter how much the importance of communication is emphasized in our training; errors in communication is one of the leading causes of sentinel events reported [1]. This is critical in graduate medical education. Since the 80 duty-hour per week restriction was put into effect [2], there is an increased number of handoffs performed by resident physicians [3]. Compared to 2003, there has been a 40% increase in handoffs performed by physicians. Boosted confidence level and increased numbers of handoffs can make handoffs more vulnerable to errors
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