Abstract
IntroductionHandoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. The issue of handoffs has not been studied in the neurosurgical literature.MethodsA validated, 20-question online-survey was sent to neurosurgical residents in all 98 accredited U.S. neurosurgery programs. Survey results were analyzed using tabulations.Results449 surveys were completed yielding a 56% response rate. 63% of neurosurgical residents surveyed had not received formal instruction in what constitutes an effective handoff; 24% believe there is high to moderate variability among their co-residents in terms of the quality of the handoff provided; 55% experience three or more interruptions during handoffs on average. 90% of neurosurgical residents surveyed say that handoff most often occurs in a quiet, private area and 56% report a high level of comfort for knowing the potential acute, critical issues affecting a patient when receiving a handoff.ConclusionsThere needs to be more focused education devoted to learning effective patient-care handoffs in neurosurgical training programs. Increasingly, handing off a patient adequately and safely is becoming a required skill of residency.
Highlights
Handoffs are defined as verbal and written communications during patient care transitions
The Accreditation Council for Graduate Medical Education (ACGME) and the Institute of Medicine (IOM) recently released guidelines limiting the number of hours that can be worked by resident physicians to minimize fatigue [2,3]
This paper explores the role of handoffs in facilitating patient safety, discusses the results of a survey of common practices among neurosurgical residents from across the country, and proposes several best practices for improving handoff communication
Summary
Handoffs are defined as verbal and written communications during patient care transitions. With the passage of recent ACMGE work hour rules further limiting the hours interns can spend in the hospital, many fear that more handoffs will occur, putting patient safety at risk. Handoffs are defined as verbal and written communications occurring between healthcare professionals (attending physicians, resident physicians, and nurses) as they transition between work shifts [1]. Handoffs refer to the process of communication occurring when someone who has been caring for a patient transfers primary responsibility of that care to another person. With mandated break periods in between patient care shifts, the need to ‘‘handoff,’’ or transfer patient care responsibilities between members of a healthcare team, has increased as housestaff physicians (residents and fellows) transition between shifts [4]. Duty-hour restrictions have led to an increased interest into investigating the safety and efficacy of these handoffs [5,6]
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