title: "Ms. B changes doctors": using a comic and patient transition packet to engineer patient-oriented clinic handoffs (EPOCH).
abstract: BACKGROUND
  Few patient-centered interventions exist to improve year-end residency clinic handoffs.
  
  
  OBJECTIVE
  Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes.
  
  
  METHODS
  The study was conducted at an academic medicine residency clinic.
  
  
  METHODS
  Participants were patients undergoing resident clinic handoff 2011-2013 PROGRAM DESCRIPTION: Two months before the 2012 handoff, patients received a "transition packet" incorporating patient-identified solutions (i.e., a new primary care provider (PCP) welcome letter with photo, certificate of recognition, and visit preparation tool). In 2013, a comic was incorporated to stress the importance of follow-up.
  
  
  RESULTS
  Patients were interviewed by phone with response rates of 32 % in 2011, 43 % in 2012 and 36 % in 2013. Most patients who were interviewed were aware of the handoff post-packet (95 %). With the comic, more patients recalled receiving the packet (44 % 2012 vs. 64 % 2013, p< 0.001) and correctly identified their new PCP (77 % 2012 vs. 98 % 2013, p< 0.001). Among patients recalling the packet, most (70 % 2012; 65 % 2013) agreed it helped them establish rapport. Both years, fewer patients missed their first new PCP visit (43 % in 2011, 31 % in 2012 and 26 % in 2013, p< 0.001).
  
  
  CONCLUSIONS
  A patient-centered transition packet helped prepare patients for clinic handoffs. The comic was associated with increased packet recall and improved follow-up rates.
authors.affiliation: Department of Medicine, University of Chicago, 5841 S. Maryland Avenue MC 3051, L326, Chicago, IL, 60637, USA, apincava@medicine.bsd.uchicago.edu.
authors.forename: Amber T
authors.initials: AT
authors.lastname: Pincavage
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Lee
authors.forename: Laura Ruth
authors.initials: LR
authors.lastname: Venable
authors.forename: Megan
authors.initials: M
authors.lastname: Prochaska
authors.forename: Daina D
authors.initials: DD
authors.lastname: Staisiunas
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Beiting
authors.forename: M K
authors.initials: MK
authors.lastname: Czerweic
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: D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D062209:Patient Handoff / Q000592:standards*; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*; D010820:Physicians / Q000592:standards*