title: Standardized sign-out improves completeness and perceived accuracy of inpatient neurology handoffs.
abstract: OBJECTIVE
  As residency programs adjust to new duty hour restrictions, the use of cross-coverage systems requiring handoffs will rise. Handoffs are vulnerable to communication failures when unstructured. Accordingly, we implemented a standardized sign-out process on our inpatient neurology services and assessed its effect on completeness and perceived accuracy of handoffs.
  
  
  METHODS
  Residents spent the first half of their rotations utilizing unstructured sign-out. They transitioned to a structured sign-out system (using the situation-background-assessment-recommendation format) during the second half of their rotations. We analyzed survey responses before and after implementation to evaluate for an effect.
  
  
  RESULTS
  Residents utilizing structured sign-out were significantly more likely to share test results with patients/families prior to shift changes (p = 0.037), update our electronic service list (p = 0.045), and feel all important data were being transmitted (p = 0.041). Overall satisfaction (scale 1-10) increased from 6.2 ± 1.6 to 7.4 ± 1.3 (p = 0.002).
  
  
  CONCLUSIONS
  Our findings demonstrate that standardized sign-out improves the completeness and perceived accuracy of handoffs. Such improvement has the potential to improve patient safety and quality of care.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA. briandmoseley@gmail.com
authors.forename: Brian D
authors.initials: BD
authors.lastname: Moseley
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Smith
authors.forename: Gloria E
authors.initials: GE
authors.lastname: Diaz-Medina
authors.forename: M Mateo
authors.initials: MM
authors.lastname: Paz Soldan
authors.forename: Meredith
authors.initials: M
authors.lastname: Wicklund
authors.forename: Radhika
authors.initials: R
authors.lastname: Dhamija
authors.forename: Haatem
authors.initials: H
authors.lastname: Reda
authors.forename: Michael F
authors.initials: MF
authors.lastname: Presti
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Britton
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration / Q000592:standards*; D009462:Neurology / Q000458:organization & administration / Q000592:standards*; D062209:Patient Handoff / Q000458:organization & administration / Q000592:standards*; D010820:Physicians