title: Improving resident morning sign-out by use of daily events reports.
abstract: OBJECTIVE
  The clinician arriving at the hospital in the morning may not yet be aware of key overnight clinical activity. To address this situation at our facility, we modified our handoff software to permit continuous updating of clinical information and the automatic relay of important overnight clinical updates to relevant providers each morning.
  
  
  METHODS
  Cross-covering residents electronically entered safety concerns and clinical issues within the reporting module of the handoff software between 5 PM and 7 AM. This updated their handoff-information at shift change and permitted the generation of reports that were emailed to primary providers and reviewed before 7 AM prerounds. At 7:30 sign-out, if a resident was already aware of an issue being signed out, he/she indicated this so that sign-out could quickly proceed to the next patient. Study sign-out duration was recorded, and residents were surveyed regarding the new communication system.
  
  
  RESULTS
  Morning sign-out duration decreased from 25.5 to 22.7 minutes (P = 0.0338). All respondents agreed strongly (12/14, 86%) or somewhat (2/14, 14%) that daily morning events reports prevented "loss of key information between shifts" and enhanced safety greatly (10/14, 71%) or moderately (4/14, 29%).All agreed either strongly (10/14, 71%) or somewhat (4/14, 29%) that the daily report improved the quality of handoff information and strongly (12/14, 86%) or somewhat (2/14, 14%) that the report was convenient.
  
  
  CONCLUSIONS
  The collection of key clinical handoff information and its automatic forwarding to incoming providers reduced the average duration of resident morning sign-out and significantly enhanced provider perceptions regarding patient safety and the quality of handoff information.
authors: From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, New York.
authors: Christopher
authors: C
authors: Nabors
authors: Dhruv
authors: D
authors: Patel
authors: Sahil
authors: S
authors: Khera
authors: Dhaval
authors: D
authors: Kolte
authors: Ridhi
authors: R
authors: Gupta
authors: Nivas
authors: N
authors: Balasubramaniyam
authors: Samir
authors: S
authors: Ambrale
authors: Nikhil
authors: N
authors: Mukhi
authors: Rajat
authors: R
authors: Lamba
authors: Vidya
authors: V
authors: Ramachandraiah
authors: Kathir
authors: K
authors: Subramanian
authors: Rashid
authors: R
authors: Syed
authors: Kyung Hun
authors: KH
authors: Nam
authors: Inderpreet Kaur
authors: IK
authors: Dardi
authors: Shoma
authors: S
authors: Bommena
authors: Varun
authors: V
authors: Mittal
authors: Stephen J
authors: SJ
authors: Peterson
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety; D058996:Quality Improvement; D012984:Software