Implementation of LURIES: A New Handoff Tool for Pediatric Residents.

Abstract

IntroductionAt our institution, inpatient pediatric residents spend about 50 hours each month on 52 total handoff encounters. We created a modifiable electronic handoff tool (LURIES) and measured its impact on resident perception of self-efficacy. We also elicited feedback and identified topics omitted in the handoffs following its adoption on general medicine, intensive care, and sub-specialty wards. Our objective was to standardize the handoff tool used by residents and to measure the impact of the new tool on resident perception of self-efficacy.MethodsResidents were trained to use LURIES and completed a voluntary online survey during the first and second year of implementation. Senior residents reflected on experiences prior to and after implementation of LURIES. Night team residents reported key items omitted from the handoff.Results65/96 (68%) residents responded in year one and 45/97 (46%) in year two of implementation. The majority of residents perceived that LURIES improved handoff efficiency, promoted active listening, and reduced the number of missed tasks overnight. There was a statistically significant increase in self-efficacy for all queried overnight tasks. Omitted information was most commonly identified on complex subspecialty services and pertained to communication with parents, late admissions, and discharges.ConclusionLURIES increased resident self-efficacy with patient management. There was no difference in findings when controlled for previous medical school handoff training or type of handoff tool used in medical school clerkships. More data are needed to establish the significance of this trend in relation to handoffs beyond residency, patient safety, and patient satisfaction scores.