Purpose: What is known about physician handoffs is almost entirely limited to resident practice, but attending physicians ultimately determine care plans and goals of care. This study sought to understand what is unique about attending intensivist handoffs, to identify perceptions of the ideal content and format of intensive care unit (ICU) attending handoffs, and to understand how ideal and reported practices are aligned in the delivery of care.
Methods: Intensivists in active practice in U.S. adult academic ICUs were purposively sampled and interviewed over 9 months in 2011 to 2012.
Measurements And Main Results: Thirty attendings from 15 institutions in nine U.S. states were interviewed. Subjects' specialties included anesthesiology, emergency medicine, internal medicine, and surgery. The "perfect handoff" was described as succinct, included verbal plus written communication, and took place in person. Respondents believed that the attending handoff should be less detailed than resident handoffs. Most attendings participated in handoffs at the end of each ICU rotation (n = 26). Standardized handoff practice was rare (n = 1). Media used for handoffs included combinations of telephone conversations (n = 25), in-person communications (n = 11), e-mail (n = 9), or text message (n = 2). Handoff duration varied from 10 to 120 minutes for 5 to 42 patients. Five of 30 respondents had undergone formal training in how to conduct handoffs.
Conclusions: A national sample of academic intensivists identified common ideal attributes of attending handoffs, yet their reported handoff practices varied widely. Ideal handoff practices may form the basis of future interventions to improve communication between intensivists.
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http://dx.doi.org/10.1513/AnnalsATS.201306-151OC | DOI Listing |
New Human Immunodeficiency Virus (HIV) cases continue to disproportionately burden cisgender Black/African American women in the United States due to a confluence of structural and systemic factors. Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention option, yet there is a striking gap between PrEP eligibility and uptake among cisgender Black women. The current study evaluates a novel warm handoff process in a hospital emergency department setting linking eligible women to local PrEP clinics within 72 hours of hospital discharge in a large southwestern metropolitan city.
View Article and Find Full Text PDFInt J Qual Health Care
December 2024
Faculdade de Medicina da Universidade de São Paulo, São PauloBrazil.
Background: Patients continue to suffer from preventable harm and uneven quality outcomes. Reliable clinical outcomes depend on the quality of robust administrative systems and reliable support processes. Critically ill patient handoffs from the operating room to the intensive care unit are known high-risk events.
View Article and Find Full Text PDFCrit Care Med
November 2024
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA.
Front Med (Lausanne)
September 2024
Department of Pediatrics, Harvard Medical School, Boston, MA, United States.
Communication underlies every stage of the diagnostic process. The Dialog Study aims to characterize the pediatric diagnostic journey, focusing on communication as a source of resilience, in order to ultimately develop and test the efficacy of a structured patient-centered communication intervention in improving outpatient diagnostic safety. In this manuscript, we will describe protocols, data collection instruments, methods, analytic approaches, and theoretical frameworks to be used in to characterize the patient journey in the Dialog Study.
View Article and Find Full Text PDFJ Surg Res
October 2024
Department of Surgery, Wake Forest University School of Medicine (WFUSM), Winston-Salem, North Carolina.
Introduction: High-quality health information handovers are critical to optimal patient care and trainee education. The purposes of this study were to assess the feasibility of implementing an emergency general surgery (EGS) morning handover and to explore its impact upon markers of clinical care.
Methods: This prospective feasibility study was conducted at a single academic tertiary-care medical center following implementation of a novel EGS morning handover process.
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