title: Assessing intern handover processes.
abstract: BACKGROUND
  New standards for resident work hours set in 2011 changed the landscape of patient care in teaching hospitals, and resulted in new challenges for US residency training programmes to overcome. One such challenge was a dramatic increase in the number of patient handovers performed by residents. As a result, there is a renewed focus for clinical teachers to develop educational strategies to optimise the patient handover process and improve the quality of patient care and safety.
  
  
  METHODS
  In order to investigate current gaps in resident handovers, we examined the handover processes performed by medicine interns at two academic medical centres in Baltimore, Maryland, USA. We used trained observers to collect data on whether handovers were conducted face to face, with questions asked, in private locations, with written documentation, and without distractions or interruptions. Results were analysed using chi-square tests, and adjusted for clustering at the observer and intern levels.
  
  
  RESULTS
  Interns successfully conducted handovers face to face (99.5%), asked questions (85.3%), used private locations (91%), included written handover documentation (95.8%) and did not experience distractions for the majority of the time (87.7%); however, interruptions were pervasive, occurring 41.3 per cent of the time. In order to investigate current gaps in resident handovers, we examined the handover processes performed by medicine interns
  
  
  CONCLUSIONS
  Interns conducted patient handovers face to face, with questions asked, in private locations, with written documentation and without distractions the majority of the time; however, interruptions during the handover process were common. Exploring gaps at the individual programme level is a critical first step to develop effective teaching strategies to optimise handovers in residency.
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Habicht
authors.affiliation: Department of Medicine, Hofstra North Shore, LIJ School of Medicine, Hempstead, New York, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Block
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Kathryn Novello
authors.initials: KN
authors.lastname: Silva
authors.affiliation: Department of Medicine, Baylor University, Houston, Texas, USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Oliver
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Wu
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Feldman
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration* / Q000592:standards; D003142:Communication; D004282:Documentation; D004777:Environment; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D062209:Patient Handoff / Q000458:organization & administration* / Q000592:standards; D061214:Patient Safety; D011446:Prospective Studies