TY - JOUR
T1 - Interunit handoffs of patients and transfers of information
T2 - A survey of current practices
AU - Kessler, Chad
AU - Scott, Nathaniel L.
AU - Siedsma, Matt
AU - Jordan, Jaime
AU - Beach, Christopher
AU - Coletti, Christian M.
N1 - Funding Information:
The authors acknowledge the members of both the Dual Section (formerly emergency medicine/internal medicine) and the Quality Improvement and Patient Safety Section of ACEP (Christopher Beach, MD, section chair) for their support and cooperation with completing this survey and their assistance in conceptualizing this project; the American College of Emergency Physicians , which supported this research through a section grant; and Jason Nomura, MD, Seema Sonnad, PhD, the Christiana Care Value Institute, and the Christiana Care Emergency Department Research Department for their support and help.
Publisher Copyright:
© 2014 by the American College of Emergency Physicians.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Study objective: We describe the current state of emergency department to inpatient handoffs and assess handoff best practices between emergency physicians and hospitalist medicine physicians.Methods: A survey was distributed electronically to emergency medicine and internal medicine physicians at 10 hospitals across the United States. Descriptive and quantitative analysis was performed on survey results. Additionally, qualitative data were obtained from an expert focus group of both emergency medicine and hospital medicine clinicians.Results: Seven hundred fifty of 1,799 physicians (42.2%) responded to our Web-based survey. Attending physicians (45%) described themselves as practicing emergency medicine (51%) or internal medicine (56%). Responding residents were 55% internal medicine, 43% emergency medicine, and 13% dual emergency medicine/internal medicine. Of the responding departments, use of standardized tools was reported by less than 20% and only one third of residents reported formal handoff training. Handoff factors identified as important include identifying "high-risk" patients, designating uninterrupted time to perform the handoff, and standardizing information provided during the handoff. Qualitative results mirrored these themes and acknowledged the importance of bedside handoffs.Conclusion: To our knowledge, this is the largest multispecialty survey to date, including both resident and attending physicians in emergency medicine and hospital medicine. Standardized tools are rarely used and training of residents in this critical task is uncommon. Physicians in both specialties agree on the important content and structure of handoff, including the ideal situation of face-to-face bedside discussion. A curriculum and assessment tool for this practice should be developed.
AB - Study objective: We describe the current state of emergency department to inpatient handoffs and assess handoff best practices between emergency physicians and hospitalist medicine physicians.Methods: A survey was distributed electronically to emergency medicine and internal medicine physicians at 10 hospitals across the United States. Descriptive and quantitative analysis was performed on survey results. Additionally, qualitative data were obtained from an expert focus group of both emergency medicine and hospital medicine clinicians.Results: Seven hundred fifty of 1,799 physicians (42.2%) responded to our Web-based survey. Attending physicians (45%) described themselves as practicing emergency medicine (51%) or internal medicine (56%). Responding residents were 55% internal medicine, 43% emergency medicine, and 13% dual emergency medicine/internal medicine. Of the responding departments, use of standardized tools was reported by less than 20% and only one third of residents reported formal handoff training. Handoff factors identified as important include identifying "high-risk" patients, designating uninterrupted time to perform the handoff, and standardizing information provided during the handoff. Qualitative results mirrored these themes and acknowledged the importance of bedside handoffs.Conclusion: To our knowledge, this is the largest multispecialty survey to date, including both resident and attending physicians in emergency medicine and hospital medicine. Standardized tools are rarely used and training of residents in this critical task is uncommon. Physicians in both specialties agree on the important content and structure of handoff, including the ideal situation of face-to-face bedside discussion. A curriculum and assessment tool for this practice should be developed.
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U2 - 10.1016/j.annemergmed.2014.04.022
DO - 10.1016/j.annemergmed.2014.04.022
M3 - Article
C2 - 24910108
AN - SCOPUS:84908073496
SN - 0196-0644
VL - 64
SP - 343-349.e5
JO - Journal of the American College of Emergency Physicians
JF - Journal of the American College of Emergency Physicians
IS - 4
ER -