title: What do patients think about year-end resident continuity clinic handoffs? A qualitative study.
abstract: BACKGROUND
  Although Internal Medicine year-end resident clinic handoffs affect numerous patients, little research has described patients' perspectives of the experience.
  
  
  OBJECTIVE
  To describe patients' perceptions of positive and negative experiences pertaining to the year-end clinic handoff; to rate patient satisfaction with aspects of the clinic handoff and identify whether or not patients could name their new physicians.
  
  
  METHODS
  Qualitative study design using semi-structured interviews.
  
  
  METHODS
  High-risk patients who underwent a year-end clinic handoff in July 2011.
  
  
  METHODS
  Three months post-handoff, telephone interviews were conducted with patients to elicit their perceptions of positive and negative experiences. An initial coding classification was developed and applied to transcripts. Patients were also asked to name their primary care physician (PCP) and rate their satisfaction with the handoff.
  
  
  RESULTS
  In all, 103 telephone interviews were completed. Patient experiences regarding clinic handoffs were categorized into four themes: (1) doctor-patient relationships (i.e. difficulty building rapport); (2) clinic logistics (i.e. difficulty rescheduling appointments); (3) process of the care transition (i.e. patient unaware transition occurred); and (4) patient safety-related issues (i.e. missed tests). Only 59 % of patients could correctly name their new PCP. Patients who reported that they were informed of the clinic transition by letter or by telephone call from their new PCP were more likely to correctly name them (65 % vs. 32 % p = 0.007), report that their new doctor assumed care for them immediately (81 % [68/84] vs. 53 % [10/19], p = 0.009) and report satisfaction with communication between their old and new doctors (80 % [67/84] vs. 58 % [11/19], p = 0.04). Patients reported positive experiences such as learning more about their new physician through personal sharing, which helped them build rapport. Patients who reported being aware of the medical education mission of the clinic tended to be more understanding of the handoff process.
  
  
  CONCLUSIONS
  Patients face unique challenges during year-end clinic handoffs and provide insights into areas of improvement for a patient-centered handoff.
authors.affiliation: Department of Medicine, University of Chicago, 5841 S. Maryland Avenue MC 3051, L326, Chicago, IL 60637, USA. apincava@medicine.bsd.uchicago.edu
authors.forename: Amber T
authors.initials: AT
authors.lastname: Pincavage
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Lee
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Beiting
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D003266:Continuity of Patient Care / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety / Q000592:standards*; D017060:Patient Satisfaction; D036301:Qualitative Research