title: Focus on transitions of care: description and evaluation of an educational intervention for internal medicine residents.
abstract: Transitions of care between physicians and from inpatient to outpatient settings leave patients vulnerable to medical errors and adverse events. A transitions of care workshop consisting of 2 sessions, Sign-Out Success (SOS) and Transition To Home (TTH), taught sign-out and discharge skills to incoming internal medicine interns during orientation. The workshop used role-playing exercises, didactics, demonstrations, and peer and self-evaluations. Interns completed a survey at 3 months post workshop. Using pre-post workshop measures, SOS increased the quality of intern-rated sign-outs (P = .004). Interns reported more confidence in their ability to effectively sign out (P = .016) and a greater understanding of problems that might arise while on call (P = .012). TTH increased intern-reported confidence in their ability to communicate discharge instructions (P < .001) and to verify patient understanding of instructions (P < .001). A majority reported using SOS and TTH skills 3 months post workshop. This workshop may be replicable at other institutions.
authors.affiliation: Johns Hopkins University, Baltimore, MD habouma1@jhmi.edu.
authors.forename: Hanan
authors.initials: H
authors.lastname: Aboumatar
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Allison
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Leonard
authors.initials: L
authors.lastname: Feldman
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Kevin
authors.initials: K
authors.lastname: Woods
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Patricia
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Charles
authors.initials: C
authors.lastname: Wiener
mesh_terms: D002983:Clinical Competence; D004493:Education; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D010351:Patient Discharge / Q000592:standards; D010360:Patient Transfer / Q000379:methods / Q000592:standards; D015397:Program Evaluation
keywords: discharges; handoffs; physician–patient communication; sign-out success; sign-outs; transition to home; transitions of care