Innovative Strategies That Improve the Clinical Handoff (l‐Switch) Phase 4: Implementing a Handoff Cognitive Simulation Curriculum Across Multiple Specialties in a Single Academic Institution

1Henry Ford Hospital, Detroit, MI
2Henry Ford Hospital, Detroit, MI
3Emory University, Atlanta, GA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 179

Background:

Learning effective handoff skills is critical lo patient safety and continues lo grow in importance since the implementation of resident duty‐hour restrictions and will likely become more critical across specialties given recent recommendations by the Institute of Medicine.

Purpose:

To apply the l‐SWITCH (Identifiers, Severity of illness, Working problems. Interventions on anticipated problems, Tests/consults pending, Code status, History) cognitive simulation curriculum on handoffs, initially developed and studied in the Henry Ford internal medicine residency program, to all incoming interns at Henry Ford Hospital in a variety of specialties.

Description:

The l‐SWITCH cognitive simulation curriculum was applied to 125 incoming interns at Henry Ford Hospital in 7 inpatient training specialties (internal medicine, general surgery, orthopedics, anesthesia, family medicine, emergency medicine, and transitional year) to address the common handoff errors that have been described by other handoff models: the current clinical condition of the patient, a plan for completing a task, and anticipation of possible overnight events. Handoff simulation training improved resident satisfaction with handoff training across specialties (44% satisfied/very satisfied with handoff training prior to intervention, 96% postintervention). Interns increased confidence in their written handoffs skills, (72% prior to intervention, 98% postintervention) and verbal handoff skills (77% prior to intervention, 96% postintervention). When surveyed, participating interns stated most often the skills they would specifically use as a result of the intervention included the ability lo anticipate clinical problems and transmit this more effectively in the handoff using “if… then” statements and to provide a more concise written and verbal handoff.

Conclusions:

A standardized handoff curriculum utilizing cognitive simulation is generalizable across several different training specialties and results in improved educational outcomes.

Author Disclosure:

A, Lukowski, none; P, Watson, none; J. Hanf none.

To cite this abstract:

Lukowski A, Watson P, Han J. Innovative Strategies That Improve the Clinical Handoff (l‐Switch) Phase 4: Implementing a Handoff Cognitive Simulation Curriculum Across Multiple Specialties in a Single Academic Institution. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 179. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/innovative-strategies-that-improve-the-clinical-handoff-lswitch-phase-4-implementing-a-handoff-cognitive-simulation-curriculum-across-multiple-specialties-in-a-single-academic-institution/. Accessed November 14, 2019.

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