Wayne State University and Crittenton Hospital Medical Center, Rochester Hills, MI
Implementing an Institutional Objective Simulated Handoff Evaluation for Assessing Resident Handoff Skill

Abstract

Background: Formal education about delivering effective handoffs is a known need for residency programs, and using a standardized process saves time and permits collaboration among programs. To address this need, Wayne State University GME created an institutional intervention on transition-of-care education. After the implementation of the institutional policy, transition-of-care task force members identified a need for monitoring resident handoff quality. For 2012–2013, the task force voted to replicate a 2010 study by Farnan et al by requiring residents to complete an objective simulated handoff evaluation (OSHE).

Methods: The task force developed a standardized template to be used by all programs for written handoffs. Each program designed a case and event that junior residents would hand off to senior residents. A total of 82 residents completed the OSHE for a 91% participation rate. Faculty champions hosted a didactic session on transitions of care, secured resident availability, scored the written handoff, and provided resident feedback. Senior residents scored the verbal handoff and gave feedback.

Results: Survey results indicated resident confidence in picking up a new service significantly increased (t=2.12, [63], P<0.05.), along with improved ability to make contingency plans (t=2.00, [63], P<0.06), to perform a read-back (t=2.08, [63], P<0.05), and to know when to perform a read-back (t=2.78, [63], P<0.01). Written template scores varied by program.

Conclusions: Institutional educational interventions accomplish several objectives simultaneously. Such interventions are a demonstration of GME engagement and permit policy monitoring that does not detract from the educational focus. The OSHE is a simple but effective tool for sampling how faculty and residents deliver handoffs and provides an ongoing opportunity to refine handoff education.