title: Are attendings different?. Intensivists explain their handoff ideals, perceptions, and practices.
abstract: OBJECTIVE
  What is known about physician handoffs is almost entirely limited to resident practice, but attending physicians ultimately determine care plans and goals of care. This study sought to understand what is unique about attending intensivist handoffs, to identify perceptions of the ideal content and format of intensive care unit (ICU) attending handoffs, and to understand how ideal and reported practices are aligned in the delivery of care.
  
  
  METHODS
  Intensivists in active practice in U.S. adult academic ICUs were purposively sampled and interviewed over 9 months in 2011 to 2012.
  
  
  RESULTS
  Thirty attendings from 15 institutions in nine U.S. states were interviewed. Subjects' specialties included anesthesiology, emergency medicine, internal medicine, and surgery. The "perfect handoff" was described as succinct, included verbal plus written communication, and took place in person. Respondents believed that the attending handoff should be less detailed than resident handoffs. Most attendings participated in handoffs at the end of each ICU rotation (n = 26). Standardized handoff practice was rare (n = 1). Media used for handoffs included combinations of telephone conversations (n = 25), in-person communications (n = 11), e-mail (n = 9), or text message (n = 2). Handoff duration varied from 10 to 120 minutes for 5 to 42 patients. Five of 30 respondents had undergone formal training in how to conduct handoffs.
  
  
  CONCLUSIONS
  A national sample of academic intensivists identified common ideal attributes of attending handoffs, yet their reported handoff practices varied widely. Ideal handoff practices may form the basis of future interventions to improve communication between intensivists.
authors: 1 Department of Anesthesiology and Critical Care.
authors: Meghan B
authors: MB
authors: Lane-Fall
authors: Rebecca M
authors: RM
authors: Speck
authors: Said A
authors: SA
authors: Ibrahim
authors: Judy A
authors: JA
authors: Shea
authors: Maureen
authors: M
authors: McCunn
authors: Charles L
authors: CL
authors: Bosk
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D062209:Patient Handoff / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D014481:United States