Residency Training in Handoffs: a Survey of Program Directors in Psychiatry
- First Online:
- 235 Downloads
The purpose of this study was to investigate how psychiatry programs are addressing the new Accreditation Council for Graduate Medical Education (ACGME) training requirements regarding transitions in patient care effective July 1, 2011.
An anonymous online survey was distributed to program directors of general psychiatry residencies within the USA. Survey questions pertaining to the 2011 ACGME handoff requirements focused on training modalities, assessment of competence, and oversight of appropriate handoff procedures. In addition, program directors were asked to share specific challenges in implementing the new handoff regulations as well as their view on how the new regulations would impact patient care.
Of the 177 recipients, 108 completed at least part of the survey (61 % response rate). Only 11.4 % of programs indicated that they did not need to make any changes to their program in order to meet the new guidelines. Approximately a third of survey respondents reported that they did not yet have a formal curriculum in handoffs (32.4 %) and/or did not specifically assess competence at handoffs (30.5 %). Program directors cited the challenge of working with a variety of clinical settings with unique cultures, infrastructure, and policies and procedures and suggested that implementation and ownership of handoff training and assessment should be at the level of the clinical services. Despite these challenges, most program directors agreed that the new ACGME requirements would improve patient care and safety.
The high frequency of programs without established handoff curricula or competence evaluations highlights the potential value of published resources and tools to provide standardized training and assessment in handoffs. The results also underscore the importance of developing training and assessment in close collaboration with the clinical services and recognizing the need to tailor handoff communications to address the types of transitions that occur within each clinical setting.
KeywordsResidency training Handoffs Sign-out ACGME regulations
- 4.Improving handoff communications: meeting National Patient Safety Goal 2E. Joint Commission Perspectives on Patient Safety. 2006; 6:9–15.Google Scholar
- 5.Triple Handoff, Arpana R, Vidyarthi MD; AHRQ Web M&M 2006 Sep; Available at http://webmm.ahrq.gov/case.aspx?caseID=134. Accessed 16 Oct 2013.
- 6.Accreditation Council for Graduate Medical Education. Common Program Requirements. 2013. http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf. Accessed 29 Oct 2013.
- 7.Wohlauer MV, Arora VM, Horwitz LI, Bass EJ, Mahar SE. Handoff Education and Assessment for Residents (HEAR) Computer Supported Cooperative Workgroup. The patient handoff: a comprehensive curricular blueprint for resident education to improve continuity of care. Acad Med. 2012;87(4):411–8.CrossRefPubMedCentralPubMedGoogle Scholar
- 8.Arora V, Farnan J, Paro J, Vidyarthi A, Johnson J. Teaching Video: “Handoffs: A Typical Day on the Wards”. MedEdPORTAL; 2011. Available from: www.mededportal.org/publication/8331. Accessed 11 Nov 2013.
- 10.Shaughnessy E. Pediatric Resident Sign-out Education. MedEdPORTAL; 2011. Available from: www.mededportal.org/publication/8321. Accessed 11 Nov 2013.
- 12.Aylward M. An interactive workshop to increase resident readiness to perform patient hand-offs. MedEdPORTAL; 2012. Available from: www.mededportal.org/publication/9189. Accessed 11 Nov 2013.
- 13.Spector N, Starmer A, Landrigan C, Srivastava R, Wilson K, Allen A, et al. West D. I-PASS Handoff curriculum: faculty observation tools. MedEdPORTAL; 2013. Available from: www.mededportal.org/publication/9570. Accessed 11 Nov 2013.
- 14.Pincavage A, Lee W, Ratner S, Dahlstrom M, Beiting K, Saathoff M, et al. Teaching Video and Checklist: “Falling through the Cracks: Year End Resident Clinic Handoffs”. MedEdPORTAL; 2012. Available from: www.mededportal.org/publication/9285. Accessed 11 Nov 2013.
- 16.Arora V. Making the most of patient handoffs: critical for patient safety & learning. April 16, 2010. http://www.slideshare.net/MergeLab/gw-uhandoffs. Accessed 11 Nov 2013.
- 17.Djuricich AM. Todd C. Evaluation of sign out and handoffs. April 2010. http://www.im.org/Meetings/Past/2010/2010APDIMSpringConference/Presentations/Documents/CRM/Wksp%201.7_Djuricich%20and%20Todd.pdf. Accessed 11 Nov 2013.
- 18.Kessler C, Shakeel F, Hern HG, Jones JS, Comes J, Kulstad C, et al. A survey of handoff practices in emergency medicine. Am J Med Qual. 2013.Google Scholar
- 21.ten Cate O, Young JQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ quality & safety. 2012;21:Suppl 1:i9–12.Google Scholar