title: Targeting improvements in patient safety at a large academic center: an institutional handoff curriculum for graduate medical education.
abstract: OBJECTIVE
  Handoffs are an integral component of patient care, and the number of handoffs has increased as a result of duty hours restrictions for resident physicians. A structured handoff curriculum improves accuracy and has been shown to decrease medical errors. A standardized approach across all specialties is lacking in the published literature. The authors discuss the development and implementation of an institution-wide handoff curriculum for incoming first-year residents.
  
  
  METHODS
  An Innovation in Graduate Medical Education committee, including faculty from multiple specialties, identified an educational deficiency in handoffs and selected this as the target for the educational innovation. Meetings were held to develop and implement an extensive handoff curriculum for incoming first-year residents. The designed curriculum included large- and small-group sessions, and a specialty-specific observed simulated handoff experience. The authors analyzed participants' pre- and postsurveys using descriptive statistics.
  
  
  RESULTS
  One hundred and twenty-four participants attended the formalized handoff training day. Following training, residents recognized that dedicated time for verbal exchange, templates for accessing and recording information, interactive handoffs giving priority to ill patients, and highlighting action items were most important for effective handoff.
  
  
  CONCLUSIONS
  Both undergraduate and graduate medical education curricula need to develop formalized training and methods to assess competencies in handoffs. Training incoming residents is a logical starting place, but programs should be systematically disseminated across all specialties, from residents to faculty, in order to be effectively integrated into the culture of an institution.
authors.affiliation: Dr. Allen is assistant professor, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, South Carolina. Dr. Caton is assistant professor, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, South Carolina. Dr. Cluver is vice chair for education and training, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina. Dr. Mainous is director, Department of Health Services Research, Management, and Policy, and professor, Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, Florida. Dr. Clyburn is associate dean for medical education, associate professor, designated institutional official for graduate medical education, and internal medicine program director, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Sarah
authors.initials: S
authors.lastname: Allen
authors.forename: Cathryn
authors.initials: C
authors.lastname: Caton
authors.forename: Jeffery
authors.initials: J
authors.lastname: Cluver
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.forename: Benjamin
authors.initials: B
authors.lastname: Clyburn
mesh_terms: D000046:Academic Medical Centers; D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D062209:Patient Handoff / Q000458:organization & administration*; D061214:Patient Safety; D015397:Program Evaluation; D058996:Quality Improvement / Q000592:standards*; D013022:South Carolina