Brief educational intervention improves content of intern handovers

简短的教育干预可以改善实习生交接班的内容。

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Abstract

BACKGROUND: The Accreditation Council for Graduate Medical Education requires residency programs to ensure safe patient handovers and to document resident competency in handover communication, yet there are few evidence-based curricula teaching resident handover skills. OBJECTIVE: We assessed the immediate and sustained impact of a brief educational intervention on pediatrics intern handover skills. METHODS: Interns at a freestanding children's hospital participated in an intervention that included a 1-hour educational workshop on components of high-quality handovers, as well as implementation of a standardized handover format. The format, SAFETIPS, includes patient information, current diagnosis and assessment, patient acuity, a focused plan, a baseline exam, a to-do list, anticipatory guidance, and potential pointers and pitfalls. Important communication behaviors, such as paraphrasing key information, were addressed. Quality of intern handovers was evaluated using a simulated encounter 2 weeks before, 2 weeks after, and 7 months after the workshop. Two trained, blinded, independent observers scored the videotaped encounters. RESULTS: All 27 interns rotating at the Children's Hospital consented to participate in the study, and 20 attended the workshop. We included all participant data in the analysis, regardless of workshop attendance. Following the intervention, intern reporting of patient acuity improved from 13% to 92% (P < .001), and gains were maintained 7 months later. Rates of key communication behaviors, such as paraphrasing critical information, did not improve. CONCLUSIONS: A brief educational workshop promoting standardized handovers improved the inclusion of essential information during intern handovers, and these improvements were sustained over time. The intervention did not improve key communication behaviors.

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