TY - JOUR
T1 - Who's covering our loved ones
T2 - Surprising barriers in the sign-out process
AU - Antonoff, Mara B.
AU - Berdan, Elizabeth A.
AU - Kirchner, Varvara A.
AU - Krosch, Tara C.
AU - Holley, Christopher T.
AU - Maddaus, Michael A.
AU - D'Cunha, Jonathan
PY - 2013/1
Y1 - 2013/1
N2 - Background: The aims of this study were to characterize obstacles affecting current sign-out practices and to evaluate the potential impact of standardized sign-out guidelines. Methods: In June 2011, detailed guidelines for transitions of care were implemented, and a 29-item multiple-choice survey was developed to assess sign-out practices, attitudes, and barriers to effective communication. Surveys were administered to residents and nurses at 3 time points. Comparisons between time points were assessed using t tests and χ2 tests (α =.05). Results: Guideline implementation achieved nonsignificant improvements in satisfaction with sign-outs, perceptions of patient safety, adequacy of information provided in sign-out, and patient knowledge by on-call residents. On follow-up, concerns surfaced regarding less complete sign-out processes due to new duty-hour restrictions. Conclusions: Guideline implementation mildly improved perceptions of safety and adequacy of sign-out; however, persistent barriers to continuity of care remain. Sign-out standardization may not adequately ensure patient safety, and further efforts to improve handoff processes are in need.
AB - Background: The aims of this study were to characterize obstacles affecting current sign-out practices and to evaluate the potential impact of standardized sign-out guidelines. Methods: In June 2011, detailed guidelines for transitions of care were implemented, and a 29-item multiple-choice survey was developed to assess sign-out practices, attitudes, and barriers to effective communication. Surveys were administered to residents and nurses at 3 time points. Comparisons between time points were assessed using t tests and χ2 tests (α =.05). Results: Guideline implementation achieved nonsignificant improvements in satisfaction with sign-outs, perceptions of patient safety, adequacy of information provided in sign-out, and patient knowledge by on-call residents. On follow-up, concerns surfaced regarding less complete sign-out processes due to new duty-hour restrictions. Conclusions: Guideline implementation mildly improved perceptions of safety and adequacy of sign-out; however, persistent barriers to continuity of care remain. Sign-out standardization may not adequately ensure patient safety, and further efforts to improve handoff processes are in need.
KW - Continuity of patient care
KW - Education
KW - Handoff
KW - Handover
KW - Residency
KW - Sign-out
KW - Surgery
KW - Transition in care
UR - http://www.scopus.com/inward/record.url?scp=84871180374&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871180374&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2012.05.009
DO - 10.1016/j.amjsurg.2012.05.009
M3 - Article
C2 - 22959413
AN - SCOPUS:84871180374
SN - 0002-9610
VL - 205
SP - 77
EP - 84
JO - American journal of surgery
JF - American journal of surgery
IS - 1
ER -