What’s New in the Patient Safety World
December
2008 Another Good Paper on
Handoffs
Another Good Paper
on Handoffs
In September we did
our Tip of the Week on “Hot Topic: Handoffs”,
citing great work done primarily by residents and other housestaff to improve
on the handoff process. Now surgical residents
at Johns Hopkins (Kemp 2008) have, based on their experiences with inadequate
handoffs, put together their “Top 10
List for a Safe and Effective Sign-out”. They stressed providing adequate
time and appropriate quiet environment for sign-outs, emphasizing the need for
sign-out to be an active 2-way interaction. They want a standardized
list/format, including items that are important to surgical patients.
Prioritizing the patients (knowing which patients are the sickest and seeing
them first) was important, as was knowing who the senior resident on-call was.
The sign-out should include outstanding tasks, outstanding lab/radiology
studies, outstanding consults, and details about any pending admissions.
Morning sign-out is just as important as evening sign-out and adequate time
should be provided for this as well.
They have included
this list and process in their intern orientation. They even include a
simulation sign-out as part of that orientation. They also discuss the utility
of web-based patient sign-out lists but note that the sign-out lists, whether
paper or electronic, should be destroyed after the on-call period to preserve
patient confidentiality.
Reference:
Kemp CD, Bath JM, Berger
J, Bergsman A, Ellison T, Emery K, Garonzik-Wang J, Hui-Chou HG, Mayo SC,
Serrano OK, Shridharani S, Zuberi K, Lipsett PA, Freischlag JA. The Top
10 List for a Safe and Effective Sign-out. Arch Surg. 2008;143(10):1008-1010
http://archsurg.ama-assn.org/cgi/content/abstract/143/10/1008
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Patient
Safety Tip of the Week Archive
What’s New in the Patient Safety World Archive