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J Gen Intern Med. 2017 Aug 14. doi: 10.1007/s11606-017-4145-4. [Epub ahead of print]

Warm Handoffs: a Novel Strategy to Improve End-of-Rotation Care Transitions.

Author information

1
Department of General Internal Medicine and Clinical Innovation, NYU Langone Medical Center and NYU School of Medicine, New York, NY, USA. Harry.Saag@nyumc.org.
2
NYU School of Medicine, New York, NY, USA.
3
Division of Pulmonary Sciences and Critical Care, University of Colorado School of Medicine, Denver, CO, USA.
4
Department of Population Health, NYU School of Medicine, New York, NY, USA.
5
Department of General Internal Medicine and Clinical Innovation, NYU Langone Medical Center and NYU School of Medicine, New York, NY, USA.

Abstract

BACKGROUND:

Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking.

AIM:

To assess the impact of a warm handoff protocol for end-of-rotation care transitions.

SETTING:

A large, university-based internal medicine residency using three different training sites.

PARTICIPANTS:

PGY-2 and PGY-3 internal medicine residents.

PROGRAM DESCRIPTION:

Implementation of a warm handoff protocol whereby the incoming and outgoing residents meet at the hospital to sign out in-person and jointly round at the bedside on sicker patients using a checklist.

PROGRAM EVALUATION:

An eight-question survey completed by 60 of 99 eligible residents demonstrated that 85% of residents perceived warm handoffs to be safer for patients (p < 0.001), while 98% felt warm handoffs improved their knowledge and comfort level of patients on day 1 of an inpatient rotation (p < 0.001) as compared to prior handoff techniques. Finally, 88% felt warm handoffs were worthwhile despite requiring additional time (p < 0.001).

DISCUSSION:

A warm handoff protocol represents a novel strategy to potentially mitigate the known risks associated with end-of-rotation care transitions. Additional studies analyzing patient outcomes will be needed to assess the impact of this strategy.

KEYWORDS:

care transitions; medical education-graduate; patient safety

PMID:
28808863
DOI:
10.1007/s11606-017-4145-4
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