Residents' and attending physicians' handoffs: a systematic review of the literature.

Purpose: Effective communication is central to patient safety. There is abundant evidence of negative consequences of poor communication and inadequate handoffs. The purpose of the current study was to conduct a systematic review of articles focused on physicians' handoffs, conduct a qualitative review of barriers and strategies, and identify features of structured handoffs that have been effective.

"Renters" or "owners"? Residents' perceptions and behaviors regarding error reduction in teaching hospitals: a literature review.

Purpose: Residents' attitudes, practices, and behaviors vary in response to medical error within the context of the culture of their institutions. The purpose of this study was to conduct a systematic review of the literature focused on residents' attitudes and behaviors regarding medical errors in teaching hospitals, including a qualitative review of barriers and proposed countermeasures related to residents' engagement in patient safety.

Method: The electronic literature databases of MEDLINE, CINAHL, and ERIC were searched for articles published between January 1988 and June 2008.

Residents' engagement in quality improvement: a systematic review of the literature.

Purpose: Residents are being asked to participate in quality improvement (QI) initiatives in hospitals and clinics with increasing frequency; however, the effectiveness of improving patient care through residents' participation in QI initiatives is unknown.

Method: A thorough, systematic review of the English-language medical literature published between 1987 and October 2008 was performed to identify clinical QI initiatives in which there was active engagement of residents. Multiple search strategies were employed using PubMed, EMBASE, CINAHL, and ERIC.

Using the Morbidity and Mortality conference to teach and assess the ACGME General Competencies.

Purpose: The weekly Morbidity and Mortality (M&M) conference, a Residency Review Committee on Surgery required conference, is a hallmark of general surgery residency training. This conference has been used traditionally to teach and assess the ACGME General Competencies of patient care and medical knowledge. The author's department has changed the format of their weekly M&M conference so that it enables them to teach and assess residents also in terms of the ACGME General Competencies of practice-based learning and improvement, professionalism, interpersonal and communication skills, and systems-based practice.

Institutioning a clinical practice guideline to decrease the rate of normal appendectomies.

With the advent of laparoscopic appendectomy, the rate of normal appendectomies increased at our institution. To decrease our rate of normal appendectomies, we instituted a clinical practice guideline in January 1999 for the preoperative evaluation and treatment of patients with possible acute appendicitis. The medical records of 464 consecutive patients who underwent either open or laparoscopic appendectomy with a preoperative diagnosis of acute appendicitis between January 1, 1997, and December 31, 2000, were reviewed.