title: Results of an enhanced clinic handoff and resident education on resident patient ownership and patient safety.
abstract: OBJECTIVE
  Although internal medicine resident clinic handoffs present risks for patients, few interventions exist. The authors evaluated an enhanced handoff.
  
  
  METHODS
  In 2011, the authors formalized a handoff protocol including a standardized sign-out process, resident education, improved scheduling, and time to establish care through telephone visits. The authors surveyed 25 residents in 2011 and 19 in 2010 regarding their perceptions and performed chart audits to examine patient outcomes.
  
  
  RESULTS
  Compared with 2010, residents in 2011 reported longer handoffs (>20 minutes, 52% versus 6%, P<.01), more verbal handoffs (80% versus 38%, P<.01), more patients aware of the handoff (100% versus 74%, P=.01), less discomfort with paperwork for patients not yet seen (40% versus 74%, P=.03), and more ownership of patients before the first visit (56% versus 26%, P=.05). In 2011, more patients saw their correct primary care provider (82% versus 44%, P<.01), and more tests were followed up appropriately (67% versus 46%, P=.02). The authors detected in 2011 a trend for patients to be seen the month their physician intended (40% versus 33%, P=.06) and a trend toward fewer acute (hospital and emergency department) visits three months post handoff (20% versus 26%, P=.06).
  
  
  CONCLUSIONS
  Enhancing clinic handoffs can improve the handoff process, increase the likelihood of patients seeing the correct primary care provider within the target time frame, reduce missed tests, and possibly reduce acute visits.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, Illinois 60637, USA. apincava@medicine.bsd.uchicago.edu
authors.forename: Amber T
authors.initials: AT
authors.lastname: Pincavage
authors.forename: Marcus
authors.initials: M
authors.lastname: Dahlstrom
authors.forename: Megan
authors.initials: M
authors.lastname: Prochaska
authors.forename: Shana
authors.initials: S
authors.lastname: Ratner
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Beiting
authors.forename: Julie
authors.initials: J
authors.lastname: Oyler
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vinci
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety / Q000592:standards*