Quality Improvement in Patient Handoff
Conditions
Keywords
Handover, Handoff, Signout, Quality Improvement, General Internal Medicine
Brief summary
Miscommunication during patient handover can jeopardize patient safety and is the focus of Quality Improvement initiatives by many organizations. It is widely recognized that such miscommunication is preventable using a number of strategies identified in the literature. Currently, there is no formal handover process of General Internal Medicine in-patients, otherwise known as the Clinical Teaching Unit (CTU) at Vancouver General Hospital, which is a major patient safety concern. This project will implement a formal handover program and evaluate whether there are changes in resident satisfaction with handover, but more importantly, whether the investigators can improve patient outcomes.
Interventions
OTHERHandover program
Sponsors
Canadian Medical Protective Association
University of British Columbia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Residents, medical students, and patients * Residents and medical students will be any rotating through General Internal Medicine at Vancouver General Hospital * Patients will be any admitted to General Internal Medicine and cared for during on-call hours (defined as 18:00 - 07:00)
Exclusion criteria
* None for residents and medical students * Patients who are not being cared for during on-call hours (defined as 18:00 - 07:00)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients handed over to the on-call resident/Clinical Associate (CA) | 5 months |
Other
| Measure | Time frame | Description |
|---|---|---|
| Frequency of patients transferred to the ICU | 5 months | — |
| Frequency of patients referred to the Critical Care Outreach Team | 5 months | — |
| Frequency of inappropriate code blue calls for patients with a do not resuscitate order | 5 months | — |
| Proportion of patients the resident on-call did not receive information on that would have been useful | 5 months | — |
| Aggregate rate of death of patients admitted to the Clinical Teaching Unit | 5 months | — |
| Resource Utilization for patients assessed by the resident on-call overnight | 5 months | Resource utilization will be defined by the ordering of: radiological imaging, blood work, electrocardiogram, blood transfusions, IV fluid administration, and antibiotics. |
| Aggregate length of stay of patients admitted to the Clinical Teaching Unit | 5 months | — |
Countries
Canada
Outcome results
None listed